Preamble

The House met at half-past Two o'clock

PRAYERS

[MADAM SPEAKER in the Chair]

Oral Answers to Questions — NATIONAL HERITAGE

National Lottery

Mrs. Angela Knight: To ask the Secretary of State for National Heritage if he will ensure that millennium fund projects are evenly distributed around the country.

The Secretary of State for National Heritage (Mr. Stephen Dorrell): Under section 26 of the National Lottery etc. Act 1993 the Millennium Commission has been issued with directions as to matters which should be taken into account when distributing lottery proceeds. These include the need to ensure that major projects are supported in each country of the United Kingdom.

Mrs. Knight: My right hon. Friend will know of the considerable interest in the millennium fund. Is he also aware that in the midlands, and no doubt elsewhere in the country, there is concern that projects in London and the south-east will get preference? Can he assure me that that will not be the case? Can he also assure me that support will be given to projects which celebrate both the heritage and the future of some of our traditional industries—such as iron, steel, lace and engineering—upon which many parts of the country such as Erewash continue to depend?

Mr. Dorrell: I can certainly give my hon. Friend the assurance that she seeks. No preference will be given to projects based in London and the south-east; the Millennium Commission has made it clear that it will proceed without trying to distribute funds according to a quota and will judge each application on its merits, from wherever in the kingdom it comes.
The type of project that my hon. Friend outlined would be particularly appropriate in Nottinghamshire and Derbyshire, and if local supporters put the idea to the Commission I am sure that it would be considered favourably. Her proposal has an attractive theme as it looks back over the past 200 years of achievement in those industries and forward to the prospects for those industries in the next millennium.

Mr. Enright: Will the Minister give particular consideration to Wakefield sculpture park which, with its Henry Moore and Barbara Hepworth collections, is a leader not only in the United Kingdom but in the world?

Mr. Dorrell: The hon. Gentleman is right to draw attention to the Yorkshire sculpture park, which is a

major centre of excellence. I am not aware whether it has made a bid to the Millennium Commission. If it has, the bid will of course be carefully considered.

Mr. Robert Banks: Does my right hon. Friend agree that it will be important for elements of the celebration of the millennium to have a theme? Does he consider that the best theme for this country would be a celebration of music? To that end, will my right hon. Friend give thought to setting up a music palace in London, which could act as a central point and which could be replicated in all our major cities? We could then leave a mark which would establish the music industry as one of our great industries.

Mr. Dorrell: I entirely agree with my hon. Friend that the Millennium Commission must back projects with themes which communicate a clear message about the things that we value when celebrating the millennium. As to whether music should be such a theme, my hon. Friend may wish to put that to the Commission. I suspect that he would need to be able to demonstrate the extra elements that the Millennium Commission could add to such a project in addition to the backing that would come from the Arts Council, which would perhaps be a more natural lottery distributor body to deal with that part of the performing arts spectrum.

Mr. William O'Brien: To ask the Secretary of State for National Heritage when he last met the organisers of the national lottery to discuss the provision of outlets for the purchase of tickets; and if he will make a statement.

The Parliamentary Under-Secretary of State for National Heritage (Mr. Iain Sproat): The provision of outlets' for the purchase of lottery tickets is an operational matter and as such is entirely the responsibility of the operator, Camelot plc, and the regulator, the Director-General of the National Lottery. The director-general meets Camelot regularly to discuss operational matters.

Mr. O'Brien: May I put it to the Minister that m many areas the organisation put in place by Camelot is not working, particularly in my constituency which covers the community council area of Normanton and Altofts with a population of about 25,000, and the neighbouring rural area of Sharlston with a population of about 27,000? There is not one outlet in that area where people may purchase a lottery ticket, so any of my constituents in the area wishing to purchase a lottery ticket must travel by bus to Wakefield or Castleford. As the arrangements made by Camelot are not working, will the Minister use his persuasive powers to ensure that my constituents and those in other areas will have an opportunity to purchase lottery tickets?

Mr. Sproat: I am sorry to hear that all is not completely well in the hon. Gentleman's constituency and I will ensure that his remarks are brought to the attention of Camelot. He may be aware, however, that by the end of this year a postal subscription service will be on offer, which should solve some of the problems. Although he has drawn attention to one or


two things that have gone wrong, it is perhaps right to point out that 11,250 outlets are working extremely successfully.

Mr. Jessel: I thank you for calling me, Madam Speaker, although I am not sure whether you will like what I am going to say. Will my hon. Friend see whether lottery tickets can be put on sale somewhere in the Palace of Westminster?

Mr. Sproat: As is often the case, my hon. Friend has suggested an interesting idea. I will certainly ensure that it is brought to the attention of the appropriate House authority.

Mr. Harry Greenway: To ask the Secretary of State for National Heritage what assessment he has made of the effectiveness of the anonymity provisions of the national lottery; and if he will make a statement.

Mr. Sproat: The anonymity provisions in the licence issued to Camelot to run the national lottery state that the identity of any person who has won a prize shall not be disclosed without the prior written consent of that person. The director general has informed me that he is not aware of any cases in which Camelot has not complied with that condition.

Mr. Greenway: Does my hon. Friend hope to win £18 million in the national lottery some day? If so, what would he do with the money, and is he satisfied that the current anonymity provisions in the National Lottery etc. Act 1993 would ensure that no one knew about his win?

Mr. Sproat: As I have said, there appears to be no doubt that Camelot has adhered to the provisions to keep winners anonymous. It may be, however, that others have not done the same. If, for instance, it was felt that complaints about what has happened in the press were proper, they could be made to the Press Complaints Commission.

Mr. Nigel Evans: To ask the Secretary of State for National Heritage how much money has been raised to date via the national lottery.

Mr. Dorrell: In the four weeks since it began, the national lottery has raised more than £53 million for good causes.

Mr. Evans: I am delighted with that response. I had rather hoped that this would have been the appropriate time for me to declare an interest, but unfortunately I am not the person who has won £17.8 million—and good luck to whoever it happens to be. As well as people winning prizes from the lottery, are not vast sums of money now set to be distributed to good causes and is it not appropriate that some of the rural areas of the United Kingdom should attract some of that money? On Friday I was talking to heads and governors of schools who would like to get funds for a swimming pool, which they would not ordinarily be able to build. Does my right hon. Friend agree that they may be able to look to the Sports Council for national lottery money to enable them to provide that facility?

Mr. Dorrell: I am sorry that my hon. Friend is not able to declare the interest that he wanted to declare. He has, of course, drawn attention to the principal

benefit of the national lottery to the great majority, because it is raising sums of money for good causes which could not reasonably have been expected from any other source. My hon. Friend has also drawn attention to the opportunity that the lottery represents for a community in his constituency to realise a long-cherished ambition. The picture that he has drawn will be repeated many times in constituencies up and down the country.

Mr. Chris Smith: In four weeks, has not the Chancellor of the Exchequer already made £25 million for the Exchequer through his 12 per cent. tax take on the national lottery? Does that not make it even more inexcusable that, as a result of the Budget statement last week, the Arts Council and the Sports Council have less money in real terms than they had two years ago, especially when arts, sport and heritage are at the very heart of the appeal of the national lottery?

Mr. Dorrell: I am at a loss to understand the hon. Gentleman's argument. He seems to be saying that, as the lottery represents an unprecedentedly large addition to the resources available to the arts and sports world, there must be an equally large addition from taxpayers' funds. The Government have made it clear that the lottery money is additional to the Government's funding to the major beneficiaries. We have delivered on that commitment in the public expenditure settlement that I announced the week before last and, in addition, the lottery is unleashing an unprecedentedly large sum towards those beneficiary groups.

Listed Buildings

Mrs. Gorman: To ask the Secretary of State for National Heritage how many representations he has received about the criteria on which buildings are listed.

Mr. Dorrell: Very few; the listing criteria were fully restated in the recent planning policy guidance note No. 15, which was the subject of wide public consultation last year.

Mrs. Gorman: I thank my right hon. Friend for his reply. Is he aware of the number of farmers who have listed barns that they are not allowed to convert for housing or light industrial use, and who are confronted with the dilemma of maintaining a building that is extremely expensive to maintain to the standards of English Heritage and other organisations and being forced to foot the bill? Will my right hon. Friend reconsider the criteria in the light of the dilemma faced by farmers, many of whom are in my constituency?

Mr. Dorrell: My hon. Friend is right to point out the importance of ensuring that in the enforcement of the listing regulations— [Interruption.]

Madam Speaker: Order. Has the hon. Member for Workington (Mr. Campbell-Savours) anything to raise? If he has, I will deal with it in a point of order after questions. The question was in perfect order.

Mr. Dorrell: My hon. Friend the Member for Billericay (Mrs. Gorman) is right to emphasise the importance of ensuring that the listing system is applied in such a way as to ensure that, while we respect the ancient buildings that are listed, the enforcement


mechanism is sufficiently flexible to allow those buildings to be put to modern, effective use. That principle is made clear in the policy guidance to which I referred.

Mr. Tony Banks: Will the right hon. Gentleman make it clear that the hon. Member for Billericay (Mrs. Gorman) cannot go around cladding her Tudor house and hoping to get away with it? Will he also bear in mind that, in terms of listing, a number of modern buildings in London need to be listed and protected? Will he make it clear that any change in the listing of that wonderful art deco building, the Hoover building on the Great West road, will be resisted?

Mr. Dorrell: We shall continue to operate the listing system in such a way as to ensure that proper respect and attention is paid to buildings of architectural importance. We shall also ensure, however, that once a building is listed it is not preserved in aspic but that the listing system is applied sufficiently flexibly to allow the building to be put to economic use in the modern world.

Mr. Steen: Listing commercial buildings without regard to economic consequences is a form of sequestration by the state without compensation. Is my right hon. Friend aware that the value of Castro] house in Marylebone road has plummeted since it was listed by the Department of National Heritage? The building is out of date and has reached the end of its life, but modern facilities cannot be put in, it cannot be Jet, it cannot be sold and it cannot be pulled down.

Mr. Dorrell: My hon. Friend is right that the listing of a building has economic consequences. It is important, therefore, to ensure that the system which lies behind the initial decision to list is sufficiently flexible to allow the heritage and economic questions to be held in the balance, and a proper and balanced judgment reached. That does not always mean preserving the building exactly as it is, but it certainly does mean respecting ancient buildings which are determined, according to the listing criteria, as being of national importance.

Battersea Power Station

Mr. Cox: To ask the Secretary of State for National Heritage which parties are involved in discussions on the future of Battersea power station; and if he will make a statement.

Mr. Sproat: The London borough of Wandsworth and English Heritage are taking part in discussions on the future of Battersea power station with the owners, and with other parties.

Mr. Cox: I note that reply, but is the Minister aware of the feeling in the London borough of Wandsworth that the destruction of the internal fabric of Battersea power station is an utter scandal, because that power station has been a major feature of the national heritage of this country? In view of the development, which was fully supported by the Conservative Government and the London borough of Wandsworth, by a developer whose ultimate aim was extremely dubious, close attention will be paid to the Minister's reply today as to the involvement that Wandsworth council will now

have. Local people have no confidence in anything in which Wandsworth council is involved relating to the Battersea power station project.

Mr. Sproat: The hon. Member is right to be concerned about what is happening to that listed building. Two of the classic pieces within the power station—the directors' staircase and the control room—are in perfect condition. The building was last examined on the afternoon of Tuesday 6 December and will be examined again before Christmas. Its condition is fine at present, but we shall be keeping a close eye on it because we share the hon. Gentleman's concerns.

National Lottery

Mr. Flynn: To ask the Secretary of State for National Heritage what is his latest estimate of the percentage of national lottery funds that will be devoted to charities.

Mr. Sproat: In common with the other four beneficiary areas, 20 per cent. of the national lottery proceeds for good causes will be devoted to charities.

Mr. Flynn: Nought out of 10 for that answer—the question involved only charities, not good causes. Is not the donor fatigue suffered by charities such as Children in Need and others a result of misleading adverts by the national lottery suggesting that large amounts of money would go to charity? Would it not be better for charity givers to buy lottery tickets from the St. David's Foundation in Gwent, where 100p in every £1 goes to charity and not merely a few pence, as with the national lottery, from which no money will go to charity until 1996 anyway? Is it not true that the charity money from the national lottery will be very little, very late?

Mr. Sproat: No, I do not agree with that. So far, £53.4 million has come in for good causes, of which the charities will receive their 20 per cent. If people want to give money to charity as well, they can continue to do so. I think that most people in this country will very much welcome an extra source of funding for charities.

Mr. Hendry: Will my hon. Friend give consideration to what should be done when the jackpot is not won and is rolled over for a second week? Does he agree that it might be better to give half the sum to good causes and charities and perhaps a quarter to smaller prizes, leaving a quarter or a third to be rolled over to the next week's jackpot? Would that not make it more attractive to punters and result in more money going to good causes?

Mr. Sproat: I do not think so. The House of Commons made a decision on the matter last year. I take my hon. Friend's point, but if there is a very big prize, many more people buy tickets, which increases the turnover and means that good causes receive more money in the end.

Arts (North-west)

Mr. Miller: To ask the Secretary of State for National Heritage when he last met the chair of the North West regional arts board to discuss the level of financial support for the arts in the north-west.

Mr. Dorrell: I have had no such meeting. Decisions on the allocation of grant in aid to the regional arts boards are a matter for the Arts Council.

Mr. Miller: Does the Minister agree with me about the importance of theatre and the arts in the regions? If he does, what is he doing about the serious problems facing theatres such as the Liverpool playhouse, which is suffering a large deficit? Does he not think that he should take direct action in the interests of protecting arts in the regions?

Mr. Dorrell: I very much agree with the point made by the hon. Gentleman about the importance of the arts in the regions. That is why I was pleased to go to Manchester last week to celebrate the success of the city of drama year in Manchester—some fine and important drama was being celebrated there. The hon. Gentleman asked specifically about Liverpool and I share his enthusiasm for ensuring that the city of Liverpool has a vigorous artistic, theatrical, musical and cultural life. That is delivered partly by state funding, which is why we have increased the money available to the Arts Council, and partly by ensuring that there is extra business support and extra support from people who visit the city as tourists and contribute to the city's artistic life through the box office. As Secretary of State for National Heritage, I intend to pursue all those avenues, not just one.

Mr. Hawkins: Does my right hon. Friend agree that one of the places where arts in the north-west are particularly strong is Blackpool, particularly at the Grand theatre, one of Frank Matcham's masterpieces? Does my right hon. Friend agree that it is important for his Department to continue with strong support for the arts in the north-west, exemplified by the support that he and his predecessor have given to theatres such as the Grand theatre, Blackpool? I hope that he will confirm today that he is able to continue to do so.

Mr. Dorrell: I can confirm that the Arts Council has continued in the current year to give very large sums of its budget to North-West regional arts. Indeed, it is the largest recipient of Arts Council grant outside London. That reflects the importance that the Arts Council attaches to stimulating and catalysing an active artistic life in the north-west of England. I stress to my hon. Friend the point that I made to the hon. Member for Ellesmere Port and Neston (Mr. Miller): this is a matter not just of public subsidy, but of using all the weapons at our disposal to ensure that the artistic life of the nation thrives and expands.

Mr. Maclennan: We recognise that the Secretary of State regards his business and his job as serious and important. Could he also tell us whether he enjoys the arts?

Mr. Dorrell: I enjoy the arts in all their many and various forms; but my job is to allow others to enjoy them, rather than regarding them as a private passion.

Mr. Fisher: Will the Secretary of State now deal with the point that my hon. Friend the Member for Ellesmere

Port and Neston (Mr. Miller) put to him about the size of the deficits of the major regional theatre companies? I am sure the right hon. Gentleman understands that those deficits cannot be met by his recipe of increased box office receipts or by sponsorship. Those might help with running costs and yearly costs, but the deficits are enormous. Our major regional theatres have cumulative deficits of more than £7 million. That is a testimony to the Government's lack of a policy and lack of concern. The right hon. Gentleman cannot get away from his responsibility for dealing with those deficits.

Mr. Dorrell: I am at a loss to understand how I am supposed to deal with the issue of deficits separately from that of running costs funding and the expansion of the arts economy to which I have referred. The way to solve a deficit is by ensuring that activity grows, generating revenue from the taxpayer, through the Arts Council, from the box office, and from the business community. That is our strategy; that is how we deal with deficits.

National Lottery

Lady Olga Maitland: To ask the Secretary of State for National Heritage what plans he has to keep under review the national lottery policy of only giving awards for capital projects.

Mr. Sproat: I shall be keeping all the section 26 directions under review.

Lady Olga Maitland: I thank my hon. Friend for his reply. Is he aware that small organisations—charities and good causes—do not necessarily need money for capital projects? They need support for sustainable activities. Crossroads, in my constituency, and voluntary "sitters" organisations, need administrative help to sustain their work of serving the community.

Mr. Sproat: My hon. Friend makes a good point. At this moment discussions are taking place between the Home Office and the National Lottery Charities Board to decide on the exact split between capital and revenue. My hon. Friend is entirely right to say that the charity sector will get, and deserves to get, much more revenue funding than capital funding. I shall see that her interesting comments are passed on to my right hon. Friend the Secretary of State.

Mr. Maxton: Although most of us would accept that the provision of sports facilities is essential and should come from the national lottery, would it not be useful if some of that money were allocated to specialised training and support for our elite young sportsmen, who find it very difficult not just to secure the use of facilities but to get time off work and proper coaching?

Mr. Sproat: That is a good point. The Sports Aid Foundation already gives some money to elite athletes, though not a great deal, I agree. We are looking at ways in which capital projects could have a revenue tail, so that there could be revenue funding for the sort of thing that the hon. Gentleman has in mind. I have also asked that the new United Kingdom Sports Council, when it gets going next year, should look into this sort of issue as a matter of priority. I certainly take it very seriously.

Cross-media Ownership

Mr. Lidington: To ask the Secretary of State for National Heritage what representations he has received about the Government's review of cross-media ownership.

Mr. Dorrell: I have received 64 written representations from a wide range of individuals and organisations. These have been supplemented by a number of meetings at ministerial and official levels.

Mr. Lidington: Does my right hon. Friend accept that the making of programmes for broadcasting is now a very competitive international industry, and that there is therefore a strong case for relaxing the present rules on cross-media ownership to enable British companies to compete effectively in that international market?

Mr. Dorrell: That view has been argued by some in the context of the review, and we are currently examining that argument along with many others. Whatever happens in future to the cross-media ownership regulation, the programme-making industry in Britain will continue to grow substantially. It provides a major opportunity for Britain in business terms, because of the employment that it creates and the wealth that it generates. It is also important in terms of the wider exposure that it gives to our way of life and ideas. The programme-making industry is one of the success stories of recent years, and whatever emerges from the cross-media ownership review should be determined, at least in part, by a commitment to ensure that that continues.

Mr. Grocott: Before the Secretary of State makes any further decisions on media ownership, would it not be a simple matter of prudent common sense to have a thorough review of the disastrous decision on media ownership that was made by his predecessor almost 12 months ago today when he relaxed the rules on the ownership of television companies? The consequences of that have been a massive 51 per cent. increase in profits by Carlton since it took over Central, bosses making a great deal of money, studios closing, many people losing their jobs and many others moving to short-term working. In view of that, does it not make simple common sense to ensure that, before changes for the future are made, one looks to the mistakes that one has made in the past?

Mr. Dorrell: It is an interesting reflection on the hon. Gentleman's presentation of his case that he spoke about the impact of the change on the company, the shareholders, the directors, the employees and the company's cost base, but did not volunteer a word about the impact on the viewer. It is the viewer who should be the driver of our policy on cross-media ownership.

Mr. Fabricant: Does my right hon. Friend agree that some British companies are suffering disadvantages compared with companies in Europe? Does he not think it better that, if there is to be an expansion of cross-media ownership and the communications industry, it should be by British companies, and specifically not by Italian and German companies?

Mr. Dorrell: My hon. Friend is right to draw attention to the opportunities for British companies to expand and fill the fast-growing international market for programme making. In reply to my hon. Friend the Member for Aylesbury (Mr. Lidington), I spoke about our success in

that endeavour to date and about my commitment to ensuring that whatever emerges from the cross-media ownership review should be consistent with our continued future success in that sector.

Mr. Allen: Does the Secretary of State accept that we understand why he wishes to delay the cross-media ownership review further? Given the media coverage that his Government are getting at the moment, he does not want to upset anyone in the media. Will he look at two areas in the review? First, rather than imposing an inflexible solution, will he consider talking to those in the industry to see whether there is a possibility of securing agreement throughout the different branches of the media? Secondly, will he consider the viewers, readers and listeners who are the consumers of these various products and understand that they want clear plurality and diversity—a choice of different mediums? Will he ensure that whatever emerges from the review he will sustain that choice?

Mr. Dorrell: Yes and yes.

Mr. Dalyell: To ask the Secretary of State for National Heritage if he will make a statement on his consideration of the problems of cross-media ownership and predatory pricing.

Mr. Dorrell: The Government are actively considering the way ahead on media ownership, and will make an announcement in due course. Alleged predatory pricing is a matter for my right hon. Friend the President of the Board of Trade.

Mr. Dalyell: What possible purpose do the right hon. Gentleman and the President of the Board of Trade imagine that Mr. Murdoch has in mind other than putting in jeopardy The Guardian or The Independent or even The Daily Telegraph by pricing his copies of The Times at 20p?

Mr. Dorrell: With all respect to the hon. Gentleman, I am not sure that Mr. Murdoch's motives are my concern. My concern is the enforcement of the law and the application of principles of public policy. The suggestion that Mr. Murdoch has been engaged in predatory pricing of The Times was examined by the Director General of Fair Trading within the terms of the law and he concluded that there was no evidence to support that. That seems to me, within the law as it stands, to dispose of the issue.

National Lottery

Mr. Jim Cunningham: To ask the Secretary of State for National Heritage if he will make it his policy that money from the national lottery will not affect the provision of public funds to sport and the arts.

Mr. Sproat: It is not intended that the money provided by the lottery should substitute for that provided by the Government in other ways.

Mr. Cunningham: Does not the Minister understand that companies such as the Coventry Theatre in Education and the Coventry Belgrade theatre could be in jeopardy because of the series of cuts imposed by the Government


in recent years? Will he speak to the West Midlands Arts Council and ensure that the future of those two companies is secured?

Mr. Sproat: I shall certainly draw the hon. Gentleman's comments to the attention of the board he mentioned.

Sir Donald Thompson: Will my hon. Friend also remember the Foundation for Sport and the Arts, a body about which none of us has anything but good to say? It has great experience and expertise and has a number of projects in the pipeline. Will he ensure that neither the public purse nor the national lottery do anything but add to the work that the foundation has done so well and should continue to do with a bigger budget?

Mr. Sproat: I certainly agree with my hon. Friend. The Foundation for Sport and the Arts and Mr. Grattan Endicott and his board have done a wonderful job, giving some £40 million to sport and £20 million to the arts. Long may that continue.

Sports (Young People)

Mr. Hain: To ask the Secretary of State for National Heritage if he will make a statement about sports provision for young people.

Mr. Sproat: The Sports Council provides financial and other assistance to enable governing bodies of sport, local sports clubs and schools to enhance their sporting provisions for young people. One of the objectives of my current proposals for restructuring the council is to strengthen the links between governing bodies and schools so that young people have wider opportunities to develop their sporting skills.

Mr. Hain: Does the Minister accept that those are mere words because the figures show that the number of physical education teachers has been cut by more than 40 per cent? There are also reduced facilities because of opting out and cuts in local government provision. Why do not the Government invest in a major national programme to boost youth sport? If we did that, as the Australians do with their cricket academies, we might start winning some test matches and other sporting events that appear to be beyond our grasp at the moment.

Mr. Sproat: I have been following with great interest the hon. Gentleman's series of questions on PE teachers to the Welsh Office and the Department for Education, which he has tabled over the past few weeks. He certainly has a serious problem in his sights. He knows the answers—such as, more teachers used to take sports but now PE teachers tend to do that; that there are fewer pupils, and so on. However, I hope that the future of PE training will be looked at in the joint paper being prepared by my Department and the Department for Education.
I agree with the hon. Gentleman's point about Australia and I am going there some time in January to look at exactly what the Australians are doing and to see what lessons we can learn.

National Lottery

Mr. Gunnell: To ask the Secretary of State for National Heritage what plans he has to meet the revenue consequences of capital projects funded through the income from the national lottery.

Mr. Dorrell: It will be for applicants for lottery funds to demonstrate that they will be able to secure on-going revenue funding for their capital projects. It is important that projects can show that they are financially viable and that they command wide support. However, in exceptional circumstances, distributing bodies do have the power to give revenue grants to lottery funded capital projects. This will ensure that good projects do not founder for lack of funding.

Mr. Gunnell: The Minister's answer is not quite satisfactory. Many projects will be started as a result of the funds available through the national lottery. When they get going, some will meet consequences that were not foreseen and were not in their business plans. The need for revenue funding will be much greater than the right hon. Gentleman suggested. Should not some lottery money be put into a trust to generate revenue funding? Many organisations working in the national heritage area are already short of revenue.

Mr. Dorrell: We have said that, in exceptional cases, the model which the hon. Gentleman anticipates—a fund-generating revenue to look after the capital asset—can be envisaged. It would not be right for us to create a fund at large to cover the generality of risk in the projects that are being backed because the responsibility for covering that risk and making viable business plans, with an element of flexibility to cover the unknown, rests on the people who sponsor the projects. I would not wish to do anything that would create among them the impression that events that were unforeseeable when the project started would be covered by an emergency fund of the kind anticipated by the hon. Gentleman. That would not be a sensible way forward. The responsibility for managing flexibility within the future life of a project must rest unambiguously on the project's sponsor.

Mr. Jenkin: To ask the Secretary of State for National Heritage if it is Government policy to use proceeds from the national lottery to support opera in its London centres as well as in the regions; and if he will make a statement.

Mr. Dorrell: Decisions on the allocation of lottery funds will be entirely for distributing bodies to make, within the framework of the directions issued to them under the National Lottery etc. Act 1993. The Arts Council will make the funding decisions in response to the applications it receives. It has recently issued guidelines for applicants which give details of its funding strategy.

Mr. Jenkin: Does my right hon. Friend agree that our opera centres in London provide extremely good value for money compared with national centres in other major countries? Would it not therefore be worth while to tip the Arts Council the wink and encourage it to push some money in that direction?

Mr. Dorrell: I do not engage in tipping winks. I engage in giving policy guidelines, which I have done.

Oral Answers to Questions — DUCHY OF LANCASTER

National Science Week

Mr. John Marshall: To ask the Chancellor of the Duchy of Lancaster if he will make a statement about preparations for National Science Week.

The Parliamentary Secretary, Office of Public Service and Science (Mr. Robert G. Hughes): Preparations are well advanced for the second science week, starting on 17 March 1995. It will be bigger and more comprehensive than this year's.

Mr. Marshall: Does my hon. Friend agree that, as part of National Science Week, it will be necessary to emphasise the quality of science teaching? Does he agree that science teaching has improved since the introduction of the national curriculum, especially in grant-maintained schools.

Mr. Hughes: Indeed, science teaching is improving. The fact that the national curriculum requires pupils to learn about science for so many years is a big improvement. Improvements in facilities are also important, but so is the excitement of science. Therefore, schools' participation in science week—I urge all schools to do so—is an important part of the public's understanding of the science curriculum.

Mr. Battle: While I welcome the Government's National Science Week initiatives, we cannot let the Minister get away with trying to con us into believing that that is all that is needed. Can he confirm that, although the Office of Science and Technology budget was riot cut last week, the budgets of every other Department—the Department for Education and the Departments of Trade and Industry, Health, Transport and the Environment—all had their research and development spending reduced in the recent Budget. Is it not a classic case of a teaspoon of aid for National Science Week while, with the other hand, the Treasury is firmly grasping the windpipe of every other Department's science spending? It was not a Budget for science, was it?

Mr. Hughes: It was a Budget for science. The Labour party apparently finds it impossible to welcome good news. Labour Members do not understand good news when it gets up and hits them. The science budget is at a record level and my right hon. Friend the Chancellor of the Duchy protected and increased it, which has been warmly welcomed in the science community.

Mr. Dykes: I wish my hon. Friend well because at the end of March he will be the Minister in charge of that programme for schools throughout the country. Can he confirm that we shall have a major programme throughout the borough of Harrow and that, although it is early days, schools are already responding well to that initiative?

Mr. Hughes: I thank my hon. Friend for his kind remarks. I know from the work which my hon. Friend and I have been doing that there will be a large programine in Harrow. Indeed, our work has been mirrored by other hon. Members of all parties who have responded warmly to the letter that I sent all hon. Members. They have been

contacting their schools and companies in their constituencies, so that everyone concerned in the subject will make a large input to National Science Week.

Mr. Cohen: To ask the Chancellor of the Duchy of Lancaster what consideration was given to animal experimentation in his sponsorship of the recent National Science Week.

Mr. Robert G. Hughes: We welcome contributions to the week from any bona fide organisation that seeks to promote greater public understanding and appreciation of science, engineering and technology. No area of research, including medical research, is excluded.

Mr. Cohen: Surely the Minister does not pretend to be neutral on the issue of animal experiments. Millions of animals are destroyed unnecessarily each year in the so-called interests of science. Why do not the Government take the opportunity provided by the week to listen to the public's views on unreliable, unethical and inhumane treatment of animals in experiments, and to promote the genuinely scientific alternatives to those awful experiments?

Mr. Hughes: I know that the hon. Gentleman is seriously concerned about the issue and pursues it with equal seriousness. I am sure that he accepts that my voting record in the House indicates that I also take a serious view of it. The Government share public concern that animals should not suffer unnecessarily. We are committed to finding alternatives and the Home Office funds research to that end. The British Association's declaration on the use of animals in medical research is an important contribution, and I am sure that the hon. Gentleman welcomes the fact that thousands of eminent doctors and scientists, including 31 Nobel prize winners, signed that declaration.

Duchy Benevolent Fund

Mr. Gordon Prentice: To ask the Chancellor of the Duchy of Lancaster if he will transfer responsibility for the disbursement of moneys from the Duchy benevolent fund to Lancashire county council.

The Chancellor of the Duchy of Lancaster (Mr. David Hunt): No.

Mr. Prentice: Does the right hon. Gentleman accept that the way that the fund's decisions are made is opaque? Last year, three of my constituents received just over £700, yet figures for each of the past five years show that one school alone—the Royal grammar school in Lancaster—receives money from the fund year after year. Should not responsibility for disbursing those funds be transferred to a democratically accountable body, rather than be vested in the few people who advise the Chancellor of the Duchy?

Mr. Hunt: I am grateful to the hon. Gentleman for giving me the opportunity to announce that over the past 10 years, the Duchy has donated more than £1 million to charitable causes. I am not one of the trustees, so I cannot comment on their deliberations and decisions—but all three Duchy Lords Lieutenant are trustees and they comment on requests for support from their respective areas. That seems quite satisfactory.

Dame Elaine Kellett-Bowman: I assure my right hon. Friend that transferring to Lancaster county council responsibility for allocating any money would be frowned upon by my constituents. Is he aware that the county council has never been fair in funding Lancaster schools, including the Royal Lancaster, and could not be trusted to be fair with Duchy money? How much money has Pendle received from the fund?

Mr. Hunt: I am grateful to my hon. Friend for supplying the correct background to the question by the hon. Member for Pendle (Mr. Prentice). This year grants totalling £2,600 have been made by the fund to charities and individuals in his constituency, from a total of £168,000.

Science and Technology

Mr. Brandreth: To ask the Chancellor of the Duchy of Lancaster what measures his Department is taking to encourage partnerships between different sectors of the economy in the areas of science and technology.

Mr. David Hunt: Many.

Mr. Brandreth: Is my right hon. Friend aware of the work of Campus, the campaign for Salford university—one of the leading universities in the north-west? It involves 150 different businesses from large multinationals to small local firms, who have formed a partnership with the university to develop research and research funding. Is not that a perfect example of the way forward, and should it not serve as a model for other universities and businesses in the north-west?

Mr. Hunt: I am grateful to my hon. Friend. The answers to his questions are yes, yes and yes.
I am impressed by the work that Salford university has done in partnership with industry, particularly the work done by Campus. Into my hands has fallen a brochure produced by the campaign to promote the university of Salford: it fell into my hands because my chief scientific adviser visited the university last October and was most impressed by all that my hon. Friend has described.

Mr. Miller: The Minister will know that I approve of the idea of increasing the number of partnerships in the science communities, especially on university campuses, but how will he avoid the potential conflict between the interests of science and those of the private sector in subjects such as genetic research?

Mr. Hunt: It is important for us to seek a positive partnership between industry and science. That is why my predecessor set up the technology foresight panels, which enable leaders of private industry to sit down with some of the country's leading scientists to discuss genetics and many other subjects right across the spectrum, and to try to look five, 10, 15 and 20 years into the future. The results achieved by the panels will emerge next spring, and will be reflected in the "Forward Look" that my Department will publish next year.

Mr. Streeter: Is my right hon. Friend aware of the partnership between the university of Plymouth and various private sector companies which are setting up the science park at Derriford, making Plymouth a centre of

scientific excellence? Is not that exactly the kind of initiative that the Government should support? I shall send my right hon. Friend a brochure in tonight's post.

Mr. Hunt: I am grateful to my hon. Friend. I look forward to reading the brochure, and to hearing more about Plymouth's efforts. They reflect the record amount of money that is being spent through the science budget, which will be more than 30 per cent. higher in real terms next year than it was 15 years ago.
The most important way ahead, however, must lie in a more positive partnership between science and industry. That is reflected in many of the efforts mentioned by hon. Members on both sides of the House in letters to me.

Mrs. Ann Taylor: Is not the Minister aware that it is extremely foolish to be complacent about the issue, especially when Britain's industrial base has shrunk so badly over the past 15 years? Surely the most urgent need for better partnerships between different sectors of the economy, and in science and technology, is in the development of information super-highways. Will the Minister acknowledge that unless the Government change direction in that vital regard, Britain will be left behind again?

Mr. Hunt: The hon. Lady should recognise that the United States has followed our example in developing the super-highway in many important and material respects. As for her general point, I am very proud of the fact that the United Kingdom is in the premier research league. Again, the science budget shows our commitment to staying in that league.

Cultures and Microbes

Mr. Mackinlay: To ask the Chancellor of the Duchy of Lancaster what consideration he has given to the report of the working group under the chairmanship of Professor Roger Whittenbury, commissioned by the Office of Science and Technology, into the safeguarding for the nation of the collection of the 42,500 cultures and microbes used by the country's science research bodies and institutes; and if he will make a statement.

Mr. Robert G. Hughes: We are grateful to Professor Whittenbury for his report, and we are considering it carefully.

Mr. Mackinlay: Does the Minister accept that that will not reassure scientists who greatly value the preservation of those cultures and microbes, which are the product of 100 years of research? It really is in the interests of the British research and scientific community for the Government to take an initiative to ensure that the microbes are preserved for the nation, and for British scientific research.

Mr. Hughes: That is the whole point of the report. The history is as follows: the House of Lords Science and Technology Select Committee report on systematic biology research expressed a number of concerns, and in our response, to meet those concerns, we set up an independent study. We now have' its report, and are considering its recommendations carefully. We consider building on United Kingdom strengths in systematic biology a very important part of overall Government plans.
Let me set the hon. Gentleman's mind at rest. Three years ago, we commissioned similar studies examining the conservation of plants in culture collections. That has worked well, and I believe that the current project will also work well.

Civil Servants

Mr. Flynn: To ask the Chancellor of the Duchy of Lancaster what new proposals he has to improve the job security of civil servants.

Mr. Robert G. Hughes: Our public service reforms, which the Select Committee recently endorsed, mean that the civil service continues to offer rewarding careers and job security which compares well with other sectors.

Mr. Flynn: Is the Minister aware that I and my constituents who work at the Patent Office were told that a decision would be made and published by Christmas—Christmas 1993? Was not that prediction as reliable as that made by the Home Secretary today that the Conservatives would win the Dudley, West by-election? Is he aware that the staff of Companies House in Cardiff, at the Accounts Services Agency in my constituency, at the Passport Office, the Central Statistical Office and the Patent Office in my constituency have the sword of Damocles in the form of possible job losses hanging over their heads for another Christmas? Will he guarantee that, if the Government privatise the agencies, the jobs involved will be secure in Wales and not moved to other parts of the United Kingdom, Europe or the far east?

Mr. Hughes: Just to fill in the background for the hon. Gentleman, the next steps agencies represent a significant improvement in the organisation of government. Although I understand that prior options reviews are unsettling for staff, and prolonged reviews are even more difficult, the Government are still considering the review of the Patent Office to which he referred. An announcement will be made as soon as the review is complete. As for the Accounts Services Agency, a decision has been made to contract out its work. It may be valuable to the hon. Gentleman's constituents who work there to know that it is expected that the staff and assets of the agency will transfer with the work.

Mr. Hawkins: My hon. Friend will be aware that the civil service is an extremely significant employer in Blackpool and on the Fylde coast, as many parts of the civil service are based there. Does he agree that job security for those civil servants will be best assured by a high quality of service to customers as exemplified by that offered by the Information Technology Services Agency, the new headquarters of which is on the outskirts of my constituency and which employs many of my constituents? Does he further agree that civil service job

security will not be improved by the type of scare stories manufactured by civil service unions of which we hear far too many?

Mr. Hughes: My hon. Friend is right. It is because of the high quality of work done by many of the agencies that so many bids have been won in house. The fact remains that people employed in agencies are there to deliver a public service; that is their primary function and it is the delivery of a high quality public service that we should all have in the forefront of our minds.

Post Office

Mr. Hain: To ask the Chancellor of the Duchy of Lancaster what plans he has to reconsider a citizens charter for the Post Office.

Mr. David Hunt: The Post Office publication, "Putting the Customer First" sets out the Post Office's commitment to charter standards.

Mr. Hain: Will the Chancellor join me in congratulating the post office workers who took a day of action today to defend the public who do not want their local high street post offices closed or dumped in the back of supermarkets? Is he aware that a MORI poll published this morning shows that 79 per cent. of the public support the strike, which is an unusually high percentage for a public service strike? Does not that show that the people of this country have no confidence in Government policies?

Mr. Hunt: No, it does not. Ninety-five per cent. of all post offices are already successfully run as private sector businesses. They offer their customers a substantial and excellent range of services. I feel strongly that today's action has no justification and I am sad that it should have taken place against the background of the most recent figures, which show that, in the past 12 months, the United Kingdom had the lowest number of strikes on record and the lowest number of working days lost on record. I am sad that today Post Office workers are seeking to add another strike to the incredibly low total. That low figure demonstrates the commitment of the vast majority of people who continue to put the customer first.

Mr. Waterson: Is my right hon. Friend aware that sub-postmasters and sub-postmistresses in my constituency are very happy with the Government's commitment to securing their future? They need no advice about running their businesses from Labour Members who are sponsored by the postal workers.

Mr. Hunt: Yes, I agree. It is evident that the service in post offices has improved tremendously. More than 95 per cent. of post office customers are now served within five minutes. In the past 10 years tariffs have risen less than the rate of inflation. Thanks to the commitment of all those who work in post offices, the quality of customer service has improved beyond recognition.

European Council

The Prime Minister (Mr. John Major): With permission, Madam Speaker, I should like to make a statement on the European Council at Essen which I attended with my right hon. Friend the Foreign Secretary and my right hon. and learned Friend the Chancellor of the Exchequer. The Council's conclusions have been placed in the Library of the House.
The European Council achieved five key British objectives: strong support for the peace initiative in Northern Ireland, including additional funding of £240 million; commitment to an intensified fight against fraud and mismanagement; solid progress on subsidiarity, and it was agreed that next year the Council will complete its review of the existing Community statute book; priority for labour market flexibility and deregulation to make Europe competitive and create jobs; and a strategy to prepare for accession to the Union of the six central and eastern European associate members.
At the request of the presidency, I briefed the European Council on the peace process in Northern Ireland. There was unanimous agreement for a Commission proposal to provide an extra £240 million over three years to help urban and rural regeneration in Northern Ireland and the border counties of the Republic. I am grateful for the strong support President Delors has given to Northern Ireland in recent weeks.
I raised the subject of fraud, waste and mismanagement of the budget following the Court of Auditors report. I said that the European Union would not enjoy popular support unless it took vigorous action against these abuses. I made a number of proposals which were agreed by the Council. These were: the Council must ensure that reports from the Court of Auditors are rigorously scrutinised and followed up; each member state must report to ECOFIN, the Economic and Finance Council, on what it is doing to combat fraud in its own country; and agreement should be reached rapidly in Brussels on measures now under discussion—these include a British proposal put forward by my right hon. and learned Friend the Home Secretary which would oblige member states to co-operate and act effectively to fight criminal fraud against the Community budget—and the new powers given in the Maastricht treaty, as a result of British initiatives, to the Court of Auditors, the European Council, the European Parliament and the Commission should be used to the full.
I made it clear that taxpayers' money must not be misused. The fight against fraud, waste and mismanagement will remain high on our agenda. That view was strongly endorsed by the Commission and a number of member states, and it echoes points that we have been making for some time in the European Council.
The European Council confirmed again that subsidiarity—the principle of minimum Community interference—must be a guiding principle of the European Union's future work, as agreed at the Edinburgh summit. I am encouraged that so far in 1994 there have been only 42 Commission proposals for significant legislation compared with 185 in 1990. But the new Commission must keep up the fight against unnecessary interference.
Discussion of the economy focused on the need to create jobs. Yet again the policies that we have been following in this country were widely accepted to be right

across the European Union. We agreed that Europe must be more competitive. We agreed on the need for more flexible working arrangements for the reduction of labour costs and for better education and training. There was nothing in our discussion to suggest that socialism had triumphed over market liberalism. The reverse is plainly the case—[HON. MEMBERS: "Test it."] I will test it with the conclusions, which show that clearly.
The European Council added three new priority transport projects to the list of trans-European networks agreed at Corfu. Four out of the 14 are United Kingdom projects: the channel tunnel rail link, the west coast main line, the rail route from Cork to Larne and the Holyhead to Felixstowe road link.
The Essen Council effectively rejected the long-debated proposal for a European Union-wide carbon energy tax. It supported instead the approach which Britain has advocated all along—a flexible framework allowing the member states hat wish to introduce a carbon energy tax to do so. We will not wish to do so.
Enlargement of the European Union has long been a British objective. At the Edinburgh and Copenhagen Councils, the decision in principle to open membership to the six countries of central and eastern Europe was taken. At Essen, leaders of the 15 European Union states, including Austria, Finland and Sweden, met their central and eastern European counterparts. Agreement at the Council on a strategy to draw the six associate members closer to the Union was another important step to help prepare for their eventual accession.
On Bosnia, there was strong support for the protection force commanders and for the work being done by the brave men and women whom they lead. They are saving lives and bringing better living conditions to many parts of Bosnia than would otherwise be possible.
We agreed that the United Nations protection forces must be allowed by the Bosnian Serbs to get on with their job without obstruction and that they should stay, provided that the risks were acceptable. It was our unanimous view that the enforced withdrawal of UNPROFOR could have disastrous consequences—above all for the people of Bosnia. But we agreed that we needed to plan for all eventualities and to keep in close touch with other troop contributors and interested Governments.
The European Council gave strong backing to the Contact group's efforts to achieve a negotiated settlement. The immediate need is for a durable ceasefire as a prerequisite to a successful negotiation.
Over dinner, the Heads of State and Government had an informal discussion about the future development of the European Union, taking account of the need for further enlargement. This was the first such wide-ranging discussion I can recall, and it was very welcome.
I emphasised the Community's achievement in helping to bring 50 years of peace and prosperity to western Europe. In squabbles over other matters, that priceless achievement is often overlooked. I also commented on the fact that 40 years ago, the founders of the Community had a broad vision of their objectives many years ahead, and that those objectives had already been exceeded.
Within a few years, we shall have around 20 members and, some time later, perhaps as many as 27 members of the European Union. The Union is changing beyond recognition. I said that it was time to rethink the Union's


future constructively and I set out the need for realism in the period ahead. That is essential if the European Union is to regain popular support.
I do not underestimate the difficult tasks the Union faces, but I was greatly encouraged by the general acceptance of the need for flexibility and for substantial changes so that the European Union can successfully meet the challenges that lie ahead.

Mr. Tony Blair: I thank the Prime Minister for his statement. I welcome the £240 million economic aid package for Northern Ireland, which was announced last week and agreed at the summit. It is another significant step on the road to peace and a recognition across the entirety of Europe of the historic opportunity to bury old hatreds.
On Bosnia, while no one can fully understand or understate the magnitude and complexity of the problems, no one can be proud of the European Union's record in dealing with the break-up in the former Yugoslavia. The inability of the west to agree or enforce clear aims and objectives for its role in Bosnia has contributed to a situation today where our troops are vulnerable, civilians are murdered, undemocratic and violent forces are in command and war crimes are, as yet, unpunished. It is particularly important that the European Union now acts in a concerted way. Will the Prime Minister insist that the economic blockade and political isolation of Serbia will not end until the Bosnian Serbs withdraw from the territory allocated to the Muslim community?
The security of our troops, whose bravery we greatly commend—I entirely agree with what the Prime Minister said about that—must come first and foremost. With that said, will he continue to impress on all our allies the disastrous consequences of a withdrawal of United Nations troops without a viable peace plan in place, not merely for Bosnia, but for the authority of the UN generally?
On the economy, may I thank the Prime Minister first for his effusive praise of Mr. Delors at the summit—something that is welcome at least on the Opposition side of the House? In particular, may I congratulate him on his welcome for the Delors paper on job creation? We agree unreservedly with the new emphasis that it places on tackling long-term unemployment and other measures, including intensive education and training; an active re-employment service; flexibility in the organisation of work, to balance family and employment responsibilities; tax rebates and other measures to counter long-term unemployment; equal rights for part-time employees; and special measures to attack youth unemployment.
I am extremely surprised, however, that the Prime Minister should represent that paper as a success for his views, as it bears out many of the points that we have been making for some time. While the document rightly stresses reducing unnecessary costs and a flexible and adaptable work force, is not the principal difference between the Conservative Government and our European partners, whether Labour or Conservative, that they see such a modern work force resulting from investment in people and technology and view it as entirely compatible with decent standards and fair treatment at the work place?
If he continues to claim that the rest of Europe is moving his way, why is his Secretary of State for Employment still having to go to the Council of Ministers

to veto social legislation? Why does he alone out of all Heads of Government, whether Conservative or Labour, veto the social chapter of fair treatment and work for people in Britain?
As the Prime Minister made such a play of that, may I raise one aspect of economic and monetary union? The presidency conclusions, which I assume he fully endorsed, say this about such a union:
The new instruments of the
Maastricht
Treaty for strengthening the convergence of our economies are being consistently used in order energetically to advance the European unification process in the economic and monetary fields".
What is the role of the Government in relation to that statement? What steps are they taking, energetic or otherwise? I am sure that that will be of interest to the Opposition parties not merely on this side of the House, but on the other side, too.
On subsidiarity, may I again welcome the communiqué's endorsement of that as the key to democratic legitimacy? Would not the Prime Minister's support for that principle abroad be more credible if he acted in accordance with it at home in the United Kingdom, instead of centralising power?
On enlargement, there is no doubt that the actual, and potential, enlargement of the Union is changing the context in which its future develops. As the right hon. Gentleman knows, we fully support the concept of enlargement. Is not the single biggest handicap to widening the European Union and including the eastern European countries, however, the existence of the tariff barriers that keep their goods out and, above all, of the common agricultural policy? Does not the process of enlargement make wholesale and fundamental change to the common agricultural policy not merely desirable but essential to its future progress? Will he confirm that the CAP still adds around £20 a week, or £1,000 a year, to the average family's food bill?
Indeed, does not that bear on the issue of fraud? Is not the CAP the main focus for such fraud? While we can all agree with the right hon. Gentleman's general sentiments and the measures he suggested on fraud, would those not carry greater weight if the Government had not recently and for the second year in succession voted for cuts in the Union's anti-fraud budget?
Although the summit was, of course, not without its successes, does the Prime Minister accept that it was low key and uncontroversial in part at least because it identified problems rather than resolved them? The big questions confronting Europe's future remain. Does he agree that, for those of us who genuinely believe in Europe and Britain's place at the heart of it, a precondition for further European co-operation is that it is decided through a debate involving the people of Europe, not merely their political elite? The debate about Europe's future should be open and the Government and other Governments within Europe should be candid about their views. They should seek to explain and justify further progress, rather than simply demand it. In short, is it not the case that the next stages of the development of Europe will come through persuasion, or not at all?

The Prime Minister: I can agree with a great deal of what the right hon. Gentleman had to say—not least because much of it was what I have been saying for most


of the past two years. I am glad to see the attention to detail which the right hon. Gentleman gives to so many of my speeches.
Let me pick up on the many points which the right hon. Gentleman raised, starting with his welcome for the £240 million over three years for Northern Ireland, which is a welcome gesture. This is additional money for Northern Ireland which is likely to be extended beyond three years provided that progress is made in the peace process during that period, as I passionately hope it will. It is a remarkable contribution which was unanimously agreed without difficulty at the European Union summit. I am delighted at the Union's support for the process in Northern Ireland, which has been evident for some time.
On Bosnia, the right hon. Gentleman was right to say that there has been an inability to enforce peace. When the whole imbroglio started, I sought advice immediately as to what would be necessary to enforce peace. The military advice which I received right at the outset—long before troops of any sort went in—was that to go in and enforce peace, we would need several hundred thousand troops who would perhaps have to be there for a very long period. Even if peace was enforced, there would be no certainty that peace without a political settlement would continue once the troops had left.
There was a possibility of huge troop commitments in the most alien territory imaginable, with the troops having to stay there even after peace had been enforced unless a political settlement had been reached. It is not possible to enforce peace, and no sensible political or military strategist ever thought that that would be possible. As far as the blockade is concerned, there will certainly be no further sanctions relief, and I can give the right hon. Gentleman that assurance.
As for the right hon. Gentleman's remarks on the economy, he would have seen—if he had been present at the debate—the extent to which the debate has changed during the past two or three years. Many of the fashionable shibboleths of two or three years ago have been utterly and completely ditched. The European Union knows that, increasingly in many parts of the Union, it is becoming less competitive compared with the rest of the world. That is less true of this country than others, but it is true across the European Union as a whole. That is becoming increasingly apparent to political leaders, not only with regard to their own economies but to their own unemployment figures as well.
That is why the Union is turning towards more liberal approaches in terms of economic management and generally greater competitiveness. The whole thrust of what was said—the right hon. Gentleman picks out little bits here and there—was an endorsement of what we have been arguing for in the European Union for many years with increasing success.

Mr. Terry Lewis: They will not be voting for you in Dudley.

The Prime Minister: Not a lot of people out there say that—certainly not with regard to the policies which the hon. Gentleman and his colleagues advocate.
On economic and monetary union and the convergence criteria, the right hon. Gentleman may not know that the convergence criteria were originally put in the Maastricht

treaty at the insistence of the British Government—not least because they are sensible economic criteria in any event, quite apart from convergence. Convergence is necessary before economic and monetary union could be a practical economic step, apart from its political or other desirability. As of today, there are probably only three nations—of which this is one—which are likely, in the foreseeable future, to meet the economic criteria set out in the Maastricht treaty. Luxembourg already does, and we are one of two others which are likely to. Those criteria are correct in their own right, not just as a means of moving towards economic and monetary union.
I welcome the right hon. Gentleman's conversion to subsidiarity. [HON. MEMBERS: "Oh!"] I see the hon. Member for Nottingham, North (Mr. Allen), who is squatting in the aisle, scoffing again at subsidiarity. That is consistent behaviour, because when I first raised the issue of subsidiarity, scoffing was precisely the reaction of the Opposition. They said that we would never get it; that it would never happen; and that it was not desirable. We have got it; it is desirable; it is central to what the Community is doing and every other nation has signed up to it. The Leader of the Opposition has signed up to it, but, alas, there seems to be a split between leader and led on the question of subsidiarity.
I share the right hon. Gentleman's view about the desirability of enlargement, not just for economic reasons, but for security and other reasons. He will know that we were the first to advocate enlargement at the Edinburgh summit. That is true of enlargement to include the EFTA countries and enlargement to include central and east Europeans. He will also know that I have repeatedly made clear my belief that the common agricultural policy was under sentence of death, provided that we enlarged to the east, so he did not have to press me on that today. I welcome him on to my ground, yet again, on that issue.
On the question of anti-fraud measures across the union, the right hon. Gentleman claimed that the budget to combat fraud had been cut. If he looks carefully at that budget, however, he will see that certain capital items that were put there last year have been paid. The revenue to deal with fraud continues at a satisfactory level and it has been agreed across the Community for that purpose.
I have a great deal of sympathy for the right hon. Gentleman's final point about the elite and Governments being out of touch with the views of the electorates across Europe. I pressed that precise view on my fellow Heads of Government in the discussion that we had on Friday evening in Essen. That remoteness has been shown by the difficulties experienced with referendums across Europe and in a raft of other ways. I agree with the right hon. Gentleman that further development of the European Union will have to carry with it the support of people across the Union.

Mr. Graham Allen: And their Parliaments.

The Prime Minister: Of course, self-evidently with the support of their Parliaments.

Mr. Allen: Not here, though.

Madam Speaker: Order. This is wasting time.

The Prime Minister: It is not practical for some enthusiasts across Europe to believe that, because they happen to think it right, everyone else is necessarily going


to follow them. There are increasing signs that that is not the case. It should not be the case and I share the right hon. Gentleman's view about that.

Sir Peter Hordern: Will my right hon. Friend accept advice from the Comptroller and Auditor General on the question of fraud in the European Union? Will he especially consider the proposition that no money should be given from Community funds until any funds from a proven case of fraud have been fully restored and restitution has taken place? Does my right hon. Friend also accept that if there are to be as many as 22 nations, or one day 27, in the European Union, a profound change must take place and that any notion of political union must become ever more distant? Is not it important that national Parliaments, which are the closest to the grass roots of democracy, should remain the natural form of democratic expression so far as we can see?

The Prime Minister: I agree entirely with my right hon. Friend. On fraud, I shall certainly look at the proposal that my right hon. and learned Friend has made. It is, of course, a first cousin to the proposal agreed at Essen that all the member states will have to report back to the ECOFIN Council on the measures that they are taking in their countries to deal with the problems of fraud. Those measures should cover fraud prevention in the first place and dealing with fraud that arises.
I see political development in the form of co-operation on an intergovernmental basis, not development in the sense of there being a political union, with political decisions centrally taken.

Mr. Paddy Ashdown: I welcome the Prime Minister's statement and, in particular, the progress made in Essen in respect of Northern Ireland and widening the Community. However, does he accept that those people who favour widening European Union also understand, as it seems that he does not, the need to strengthen Europe's institutions and make them more democratic and flexible if that is to be coped with effectively? In that case, does he realise how welcome it is that the Government should be taking, albeit tentative, steps towards defence integration, especially with the French? Do not the failures in Bosnia, and more recently the worrying situation in Chechnya, make that even more urgent? Will he assure the House that he puts that at the front of the Government's agenda for the 1996 intergovernmental conference?
Finally, the Prime Minister has said, rightly, that Britain's policy on Europe should depend on a widespread debate that involves the people of Britain and the people of Europe. It should not depend on the untidy outcome of an unseemly spat led by rebels in his divided party. It will be greatly welcomed that he is now changing his mind on the issue of a referendum. He has said that there might be circumstances in which a referendum would be appropriate. Will he now tell us what those circumstances would be?

The Prime Minister: I am grateful to the right hon. Gentleman for his support on Northern Ireland and enlargement. He is also right about the European Union itself becoming more democratic, although many people may mean different things when they say it. I certainly

think that there needs to be more accountability by the Commission to the European Council. That is the primary democratic focus of the European Union.

Mr. Derek Enright: The European Parliament.

The Prime. Minister: If the hon. Member for Hemsworth (Mr. Enright) would do me the courtesy of listening to what I have to say, he might not have had to shout. He could have saved himself some breath.
The European Council is made up of members from the individual democratic domestic Parliaments. The European Parliament is not the primary focus for democracy throughout the European Union. As Labour Members were shouting at me a moment ago, not least from below the Gangway, it is here that the primary democratic institution lies, and not the European Parliament. I am interested to see an apparent divergence between the hon. Gentleman and his hon. Friends on that matter.
On defence, I think that there is scope for more defence co-operation across Europe. I think that there is a great deal to commend that. It is an aspect that we have been examining for some time, and that we shall continue to examine for some time. I think that it is right on its merits, right for the defence of Europe and right for other reasons. I suspect that that will be an issue in the intergovernmental conference in 1996, although much of it has been developing for some time. We have not generally recognised the fact that we probably have more joint defence co-operation with France than we have had with any other nation in Europe, and perhaps any other nation anywhere, for very many years.
I made it clear that I did not rule out a referendum. One will have to wait and see precisely what the circumstances are. I think that it is wise to wait and see precisely what the circumstances are. The right hon. Member for Yeovil (Mr. Ashdown) does not know what will happen in the future, and his past projections of what might have happened today have proved that he does not know what will happen in future. So I have indicated that the circumstances might be appropriate to have a referendum, and if they are, we will.

Several hon. Members: rose�ž

Madam Speaker: Order. Those initial exchanges have now taken something like half an hour. I am now insisting that Members restrict the length of their questions to the Prime Minister. I am sure that, for his part, the Prime Minister will respond briskly, so that I can call as many Members as possible.

Mr. John Biffen: May I congratulate my right hon. Friend on the part that he played in keeping the Council meeting in a low key. May I ask one question? In the discussions that took place at the dinner meeting, and which touched on the complexities and challenges of enlargement, how many Heads of State expressed the opinion that the single currency would impede rather than facilitate enlargement?

The Prime Minister: Most Heads of Government pitched their remarks to what was likely to happen in the next 20 or 30 years, rather than looking at each individual item, so no one directly either supported the necessity for


a single currency or specifically objected to a single currency. The debate ranged a good deal wider and a good deal further than that.
However, I think that my right hon. Friend knows the Government's position on a single currency. We sought in the Maastricht treaty to retain a freedom for the House to decide at a later date whether it was in the interests of this country to join. I am sure that that is the right position for the House to maintain.
It is clear that one of the reasons why a single currency has tended to fall away from the standard European debate that we have known so much over the past couple of years is that there is now no doubt in anyone's mind that the original timetable for a single currency is not remotely likely to be met—it will be a good deal later. Although some people are still flirting with the possibility of a single currency among some countries by the turn of the century, others have their doubts about the desirability of that.
What is clear now is that, whereas before the Maastricht treaty many people had in mind the concept of a single currency right across membership of the European Union, that is plainly fatuous if the Union is to be extended to 27 members. It will be almost totally unlikely if it has 20 members and extremely unlikely for 15 members. Most people are concentrating on a small core who may or may not decide to proceed. That carries a good deal more with it than simply an economic judgment. If a small core went ahead without the others, it would materially change relationships within the European Union.
I apologise to you, Madam Speaker, for that lengthy reply and shall try to obey your injunctions in future.

Mr. Peter Shore: We can all welcome the steps towards extending the European Union towards central and eastern Europe, but it is a rather different matter when we turn to the institutional changes or conditions that are referred to as a prerequisite for extending the Union. Is not a phrase such as "institutional conditions" just a code for the further tightening and centralising of the decision-making process inside the European Union?

The Prime Minister: Coming from where he does on the issue, I understand why the right hon. Gentleman thinks that. But I would say to him that, no, that is not the case. I shall give but one illustration of the sort of thing that we have in mind. Every time nations have joined the European Community in the past, one or two extra Commissioners have been added, which is patently absurd and cannot continue. There are too many Commissioners now and we should cut the number. I fervently hope that that will happen in 1996. Clearly, we shall have to have a smaller number. One of the institutional changes to be discussed is a change of that sort, which I think that the right hon. Gentleman would welcome. I think that he would welcome many others, too.

Sir Terence Higgins: Is it not absurd for those who argue that the authority of the House is being undermined by Brussels to argue for a referendum—an alien concept that is incompatible with a representative parliamentary democracy? In that context, would it not be particularly absurd to have a referendum on a single currency when most people do not know the difference

between a single currency and a common currency? In addition, as my right hon. Friend has said, because of enlargement, that is not likely to be an issue for many years.

The Prime Minister: It is certainly not likely to be an issue for many years. As my right hon. Friend will know, I advocated the principle of a common, as opposed to a single, currency some time ago, and I still believe that that would have been the best way forward. It would benefit business and industry—the prime beneficiaries in terms of the economic advantages of a single currency—without the disruption, both politically and historically, to the domestic currency that has become so familiar and beloved of people across the European Union. I remain of the view that, if it is possible to persuade others, a parallel currency is the right way ahead—I am sure that that is right.

Mr. Tam Dalyell: Was anything said about sanctions against Libya by either the Germans or the Italians, who do not observe them, in view of the fact that 5,000 British nationals work there and British industry is greatly disadvantaged?

The Prime Minister: That was certainly not discussed by the Heads of Government and, to the best of my knowledge, it was not discussed by the Foreign Ministers in their meetings.

Mr. William Cash: Will my right hon. Friend say no now to a single currency, given the fact that, under section 2 of the European Communities (Amendment) Act passed last year, if there were a Labour Government with a massive majority, they would put into effect a single currency through the mechanism already provided? Therefore, when my right hon. Friend considers whether there should be a referendum, will he ensure that the referendum takes place before the next intergovernmental conference so that we can ensure that we preserve the very rights that my right hon. Friend mentioned in his opening remarks?

The Prime Minister: The IGC will have nothing to do with the single currency—it is not likely to be on the agenda at all.

Mr. Robin Cook: Come off it.

The Prime Minister: It is not likely to be on the agenda—the shadow Foreign Secretary can be reassured about that.
As for ensuring that a future Labour Government would not take us into a single currency, my hon. Friend's complete support to ensure that there is no future Labour Government would perhaps be the most agreeable way to ensure that that does not happen.
I think it right for us to determine what the circumstances are, in the longer term, when the question of a single currency will arise. That must be in our national economic interest. It is why I think we reached the right conclusion at Maastricht: not to sign up now to something in the unknown future, in unknown economic circumstances, and to keep open the option if it is in the economic interests of this country at the time.

Mrs. Gwyneth Dunwoody: If the Prime Minister is serious in what he says about power residing in national Parliaments, will he advocate giving


the European Committees the power not only to amend suggestions from Ministers but to vote on them on the Floor of the House as a matter of routine?

The Prime Minister: If the hon. Lady, or any Government, did that, they would make any discussions or negotiations in the European Union almost an impossibility, the more so given the size of its membership, as it widens, which we all want. Whatever the underlying democratic desirability of what she suggests, it would be impractical. It would effectively be a way to kill any activity and almost any progress in Europe.

Mr. Winston Churchill: May I congratulate my right hon. Friend on the forthright way in which he fights to defend British interests in the European Union—and on the way in which he survives repeated political assassination attempts by certain quarters of the British media?
If there were a clear prospect of a transfer of sovereignty away from this country to the European Union, would my right hon. Friend ensure a referendum before such a transfer took place?

The Prime Minister: I am grateful for my hon. Friend's kind words and for his concern for my physical and political welfare. I am very touched indeed, and I look forward to his thoughts spreading.
Constitutional change is not a matter to be taken lightly or trivially. I have said in the past that I do not traditionally favour referendums in a parliamentary democracy, but I recognise that there may be occasions—Northern Ireland was a recent one—when a referendum would be appropriate.
A referendum has been suggested for two matters: one is the outcome of the IGC; the other is the single currency. We do not yet know the agenda for the IGC, and a single currency is still a long way off, and possibly getting further away. On matters of such exceptional importance, as I have said, a referendum cannot be excluded.

Mr. Enright: Is not the Prime Minister aware of how incensed Christian Democrats, as well as socialists. on the continent are at his continued attempts to frustrate directives that seek to treat workers as human beings? Does he not realise that the attempt last week by the Secretary of State for Employment to block the directive on building firms that exploit cheap labour has infuriated the general populace on the continent?

The Prime Minister: The hon. Gentleman is talking absolute codswallop. This country has the best health and safety record in Europe, and he should know that. If there is frustration across Europe, it is likely to be found in the countries where unemployment is still rising because they are not following the policies that we are in Britain, where it is falling.

Mr. Ray Whitney: Does my right hon. Friend agree that the successes of the Essen summit underline again the benefits of British membership of the EU? Does he share my hope that the British media, just for once, will report those successes fully and honestly, so that our people can understand that Britain's future does indeed lie at the heart of Europe?

The Prime Minister: I travel hopefully on the substantive part of my hon. Friend's question. I wish our

membership of the European Union to be a success for this country. Thus far, over the past 20 years or so, economically it has been an immeasurable success. I think that there is no doubt about that, and the European Community, now the European Union, has undoubtedly been a dramatic success for living standards and for security and peace across western Europe. Those are much bigger issues than many of the matters which engage us in trivial and sometimes not so trivial arguments with our European partners. I want our membership to be a success. I intend that to continue, and I have no intention of acting in a way that would damage that.

Mr. Dennis Skinner: How many more summits does the Prime Minister expect to attend? Did he tell them, including the other Prime Ministers who are also teetering on the brink in the Common Market, that if he had not got rid of those eight Members by removing the Whip, there would have been 34 votes against him and he might not even have made that journey?

The Prime Minister: Dear, oh dear, oh dear. I think that the hon. Gentleman is aging. I assure him that that was not discussed in the European Union discussions at Essen. To my knowledge the hon. Gentleman has been making remarks like that since before the last general election. Much to his great dismay, no doubt, he has been wrong all the time.

Mr. Hugh Dykes: May I congratulate my right hon. Friend on defending the legitimate as opposed to the hysterical interests of the United Kingdom in the European Union? If ours is the most competitive economy, why is it that of the big four we are the only one with a trade deficit? As the pound has been repeatedly devalued since the war, what fantasy are we defending?

The Prime Minister: If my hon. Friend looks at the growth pattern and in particular the export growth pattern, he will find that we are doing far better than any other nation in the European Union at the moment. As we came out of the recession the fashionable view was that our balance of payments gap would be very wide. It was often advanced by the shadow Chancellor in his moments of gloom—indeed, he has nothing but moments of gloom—that, as we emerged from recession, the balance of payments gap would widen and widen. It has, of course, narrowed and narrowed, and the reason for that is our competitiveness.

Mr. Donald Anderson: Is it not an exercise in self-delusion for the Prime Minister to conclude from this inconsequential summit that our partners are moving on to his ground? Surely the reality is that France and Germany and others are moving ahead behind the scenes with economic and monetary union proposals, and that at some stage he will have to choose between pandering to those behind him, whose paternity he has doubted in the past, and the interests of the country.

The Prime Minister: If the hon. Gentleman wants to look at self-delusion he should look in the mirror. As for the summit being inconsequential, I refer to the £240 million for Northern Ireland, the fraud commitment, developments on subsidiarity, deregulation and competitiveness, the strategy on enlargement, and the historical impact of having another six nations attending


the European Union summit. If those are inconsequential, heaven help us from what the hon. Gentleman thinks would be consequential.
On monetary union, I suggest that the hon. Gentleman compares some of the more recent speeches by European leaders with those of two years ago. He might, for example, look at Mr. Balladur's recent speech and at what President Mitterrand had to say at our joint press conference in Chartres. If he had done that, he would be better informed and would not have asked that question.

Sir Teddy Taylor: In view of the continued uncertainty in the fishing industry, would the Prime Minister care to clarify the statement by Mr. Gonzales in Madrid this morning that he was overjoyed at what he saw as a crucial breakthrough over fishing? Is it true that he forced this issue on to the agenda, that a crucial breakthrough was achieved, and that he got what he came for? Does the Prime Minister accept that, when such statements are made by foreign Prime Ministers, and particularly in the context of our fishing industry, it is helpful to have the issue clarified and a statement made so that the whole House knows what is going on, or whether a statement is a load of rubbish?

The Prime Minister: I have not seen that remark by Prime Minister Gonzales, but it is not entirely unknown for Prime Ministers abroad to make statements for domestic reasons—[Interruption.] That does not, of course, apply to British Prime Ministers. It applies occasionally to Prime Ministers elsewhere who do not find themselves subject to the same rigorous questioning in their Parliaments as we do in ours. Indeed, I must say that some of my fellow Heads of Government could scarcely find their way to their Parliaments with a guide dog.
On the point about fishing, it has been agreed that the new rules must lead to no increase in effort, including for the Spanish fleet. There was no great breakthrough, no great change, and the issue will be debated in the House later this week.

Mr. Denis MacShane: That last insult to every Prime Minister in Europe really takes the biscuit. More seriously, if, as we know, the Prime Minister cannot speak for his party but claims that at least he speaks for his Cabinet, why is there not a single Europhobe Cabinet Minister sitting on the Front Bench with him today?

The Prime Minister: Dear, oh dear. I am not really sure why the hon. Gentleman bothered to ask that question and it certainly does not merit a reply.

Sir Wyn Roberts: Does my right hon. Friend accept that the undoubted successes that he achieved at Essen, which were grudgingly welcomed by the Leader of the Opposition, will be warmly welcomed in many parts of the country? He should be congratulated on his part in achieving them.
On the economic front, is it not a fact that last week Mr. Delors described the policies pursued by my right hon. Friend and his predecessors as ultra-liberal economic policies which he was happy to thwart with socialism?

Have not Conservative policies been well and truly vindicated as the only possible policies to be pursued in Europe to reduce unemployment and create jobs?

The Prime Minister: Not only do I believe that to be overwhelmingly the case, but I believe that that is the view of most of the people who attended the Essen summit.

Mr. Peter Mandelson: As the Prime Minister is in candid mood today, will he tell us how he would pitch his enthusiasm for a strengthening of the EU's common foreign and security policy, in view of recent comments by the Foreign Secretary? What institutional changes within the EU would be required to allow such a strengthening?

The Prime Minister: A common foreign and security policy in the European Union is a relative novelty, following the Maastricht treaty. It is still in its infancy. We think that it can easily be further developed, but on the basis of co-operation, not qualified majority voting. Therefore, it would continue on an intergovernmental basis, but based on co-operation.

Mr. Jacques Arnold: I welcome the announcement on the trans-European projects, especially the funding for the channel tunnel rail link. Not least, it will fund some of the environmental improvements already agreed. May we have an assurance that European environmental funds will not be excluded from further environmental improvements in Kent?

The Prime Minister: I think that I can give my hon. Friend that assurance. Of course, I cannot guarantee that more funds will necessarily become available. I do not know whether they will or what priorities will emerge, but they will certainly not be artificially excluded.

Mr. Llew Smith: Has the Prime Minister read the report in The Times today, which states that the summit decided that job security and welfare benefits should be reduced to cut the queue of 17 million unemployed? If the report is true, why did he not mention it? Can he explain how cutting job security and welfare benefits will increase employment?

The Prime Minister: I do not know precisely what The Times is referring to—

Mr. Smith: Here it is.

The Prime Minister: I am not quite that long-sighted. I did not read that report, but I suspect that it is an extrapolation of the argument that unless we are competitive we will lose jobs. That has been happening across the whole EU, where 18 million to 20 million people are unemployed. If the number continues to rise, it will be an extremely serious long-term problem for the EU. The number has been rising almost consistently since the 1950s as we have become progressively less competitive. I suspect that the article which the hon. Gentleman has in mind indicates the need to retain competitiveness across Europe to ensure that more people are put back into work.

Mr. Edward Gamier: May I congratulate my right hon. Friend on what might be described as a dull and businesslike meeting at Essen?


Will he confirm that quiet confidence at such meetings will achieve what this country needs: enlargement, competitiveness and subsidiarity?

The Prime Minister: I entirely agree with my hon. Friend about that.

Mr. David Winnick: It was a difficult one, was it not?

The Prime Minister: I entirely agree with my hon. Friend's wise words on that subject, and he is right to stress them. The hon. Member for Walsall, North (Mr. Winnick) might have put it differently, but I prefer my hon. Friend's formulation.

Mr. Nigel Spearing: In his reply to my right hon. Friend the Member for Bethnal Green and Stepney (Mr. Shore), the Prime Minister suggested that the institutional conditions before enlargement were largely mathematical—matters such as seats. Has not the presidency, in the form of Chancellor Kohl and his friends, advocated increasing the powers of the European Parliament? Does the Prime Minister agree, therefore, that even if his Government do not believe in increasing those institutions' powers, other members of the reflections group at the 1996 conference probably will?

The Prime Minister: Yes, some of them will certainly want more powers, as the hon. Member for Hemsworth (Mr. Enright) said earlier, although I was not entirely sure whether he was in favour of or against them.

Mr. Enright: In favour.

The Prime Minister: He is in favour of them on this occasion—good. So some people will argue for that in 1996. The illustration that I gave the right hon. Member for Bethnal Green and Stepney (Mr. Shore) was just one example of the sort of matter that will be discussed in 1996. One could give others. I have no doubt that some will argue for changing the powers of the European Parliament. There will be a range of proposals, but whether they will be agreed is a separate matter.

Mr. David Harris: Will my right hon. Friend take the opportunity to refute completely the allegations and suggestions made by the Labour and Liberal Democratic parties that a backstage deal that will do down our fishing industry was stitched up at the summit? Will he assure the House that, at the Fisheries Council meeting next week, which is particularly vital to south-west England, we shall retain our position and robustly defend our fishermen's interests?

The Prime Minister: No backstage deal has been done. We have succeeded in setting aside the complex solution put forward by the Commission in September, which was not in the interests of British fishing. Instead, the Council agreed in its conclusions that a non-bureaucratic solution would need to be found. We shall continue to consult the fishing industry. Our objectives remain to ensure the following: that British fishing interests are protected; that only necessary

measures are agreed; that fishing effort should not increase; and that the ability to take quotas is uninhibited.

Mr. Tony Banks: Before it develops into a story throughout Europe, would the Prime Minister care to rethink the gratuitously insulting words that he offered his colleague Prime Ministers on their inability to know where their Parliaments are, not to mention his insult to guide dogs? Other Prime Ministers may have their Parliaments under greater control than he has his own. Why does he object to the European Parliament having greater democratic powers? Why should it not be the democratic institution for Europe? After all, its members are elected as well, and national Parliaments seem incapable of getting democracy into the European Union.

The Prime Minister: I hope that the hon. Gentleman's words will gain wide currency. If he implies that he wants a significant movement of authority from this House to the European Parliament—

Mr. Tony Banks: indicated assent.

The Prime Minister: I note that the hon. Gentleman is nodding. He therefore wants a significant movement of powers from this House to Europe.

Mr. Skinner: No.

The Prime Minister: There seems to be slight dissent from other Labour Members.

Mr. Skinner: We may disagree, but at least we all have the Labour Whip. [Interruption.]

The Prime Minister: Perhaps the difference is not so slight. There is a fundamental split between not just Opposition Members but left-wing Opposition Members, with Opposition Front-Bench Members no doubt sitting uneasily in the middle. Thank heavens that that sort of thing only happens there.

Mr. Michael Spicer: I agree with the tone of much that my right hon. Friend said, particularly in respect of the European Commission, Parliament and Council. However, I believe that my right hon. Friend said that a single currency is unlikely to come about in the near future. Is not that difficult to square with the treaty, which states that a single currency must come about by 1 January 1999? Was my right hon. Friend implying that the treaty must be amended, so that the timetable will not be fixed?

The Prime Minister: Originally, in 1972, there was agreement on a single currency by 1980. That patently did not happen because neither the economic circumstances nor the political will were right. It is certainly the case that the economic circumstances will not be right for 1997. It is extremely improbable that the right economic circumstances will be widespread in the Union in 1999—and they, too, are written into the Maastricht treaty as a necessary precondition for a single currency. That certainly applies to a European Union of 12, 15 or whatever number of states. It is conceivable, though no one yet knows, that a smaller group of member states might be ready by 1999. Even if that were the case, they would need to consider carefully the implications for the whole European Union


if they adopted a single currency when the others—whether or not they wanted to go ahead—were not economically in a position to do the same.

Mr. Andrew F. Bennett: The Prime Minister reported that the summit agreed to abandon the proposal for a carbon tax. Did the summit reaffirm commitment to the Rio targets? If so, how will the British Government meet their commitment?

The Prime Minister: A European Union conference on environmental matters will be held in Berlin in the near future. The summit touched on environmental matters only in general because it agreed that those matters and the Union's position at the Berlin conference should be discussed at the Environment Council next week.

Mr. George Kynoch: I welcome my right hon. Friend's statement. Does not it demonstrate the United Kingdom's great influence on European affairs? Does my right hon. Friend agree that it would be disastrous for all parts of the United Kingdom if that single, strong voice were put at risk—as it surely would be under Labour's proposals for constitutional reform?

The Prime Minister: That is undoubtedly the case. I have forcefully expressed my views on that issue in the past. If the United Kingdom did not have a single, unified voice in the European Union, it would not have the same force of argument. That does not apply exclusively to the Union, because it would also be the case in the United Nations, G7 and every other international forum where Britain currently sits at the top table. A divided United Kingdom, perhaps leading to parts of it being separated, would not allow it to retain that position.

Mr. Barry Jones: Did the Prime Minister raise at the summit the difficulties confronting the British aerospace industry? Did France and Germany raise with him the need for the British Government to purchase the future large aircraft? I hope that they did. Is the right hon. Gentleman aware that my constituents,

who manufacture the European Airbus, are terrified that the Government will buy Hercules and not place orders for the FLA?

The Prime Minister: No, the British aerospace industry was not discussed—although it is, of course, important. Much of the present Hercules fleet will need either substantial refurbishment or replacement. We must consider whether to go wholly or partly for refurbishment, buy new planes now, or buy some new planes now and develop the future large aircraft. Those matters are under active consideration and no conclusion has yet been reached.

Mr. Tim Smith: Is my right hon. Friend aware that there will be a warm welcome for the additional funds destined for Northern Ireland? Did not President Delors take a particular personal interest in the Northern Ireland peace process? Will my right hon. Friend confirm that the funds will genuinely be additional and directed at areas of greatest economic and social need?

The Prime Minister: My hon. Friend is entirely right. From the moment of the Downing street declaration, President Delors has been particularly helpful in regard to developments in Northern Ireland. I am very grateful to him for the personal effort that he has put in, and the personal part that he played in ensuring that this substantial package of extra assistance for Northern Ireland and the border counties of the Republic would be made available. It will be used for projects to promote reconciliation, encourage economic growth and expand job opportunities.

Mr. Harry Barnes: Is it not disappointing that nothing was done at Essen to tackle the democratic deficit? Should not powers move to the European and national Parliaments, and away from secret bodies such as the Council of Ministers?

The Prime Minister: I am not sure that I would describe the Council of Ministers as a secret body. No one who attends its meetings would regard them as at all secret. Given that everyone holds press conferences immediately after the meetings, that conclusions are published, that some of the meetings are open nowadays and I will answer questions about them—as, no doubt, will others—I do not think that they are terribly secret. I am not sure that the hon. Gentleman is on the strongest ground.

Several hon. Members: rose—

Madam Speaker: Order. We shall now move on.

Points of Order

Mr. Frank Cook: On a point of order, Madam Speaker. Last Thursday I reminded the House that the implementation order relating to local government reorganisation in the county of Cleveland was still before the courts. At that time, the Lord President of the Council effectively withdrew the assurance that he had given in June this year that progress on the order would await resolution in the courts. I submit that that in itself was a hindrance to proper procedure.
On 10 March, the Parliamentary Under-Secretary for the Environment assured the House that his Department would
place in the Library a summary of all representations received by the Secretary of State about the Commission's final recommendations"—[Official Report, 15 March 1994; Vol. 239, c. 577.]
when the Government laid the implementation order for Cleveland. He repeated that promise on 31 March. The order was laid last Thursday—nine months after that promise was made to the House, and 13 months after the Banham commission made its infamous recommendation. Despite repeated telephone calls from Library staff to the Department throughout Thursday, Friday and today, the summary of submissions has not yet been deposited in the Library.
Not only has the Secretary of State for the Environment treated the people of Cleveland with cynical non-concern by denying them a proper means of registering their preference; he has breached faith with the House by failing to keep his word, thus depriving hon. Members of information that could be crucial to the making of proper representations. May I ask you, Madam Speaker, to make the appropriate investigations of this disgraceful breach of faith?

Madam Speaker: From what the hon. Gentleman has said, the Department appears to have been very lethargic. Ministers will have heard that exchange, and I hope that they will report it to the appropriate Department without delay.

Ms Angela Eagle: On a point of order, Madam Speaker. A couple of hours ago, I heard that the North West gas board had introduced a £21 call-out charge for gas leaks. I am extremely concerned that that may lead to dangerous circumstances in the north-west. Will you advise me, Madam Speaker, on how I might raise the issue in the House as a matter of urgency?

Madam Speaker: Advice on procedure is not given across the Floor of the House, but I am sure that the hon. Lady—who is wily in the ways of getting things done in the House—will find methods of doing so before the House rises: indeed, in the next day or two.

Orders of the Day — Health Authorities Bill

Order for Second Reading read.

Madam Speaker: Before I call the Secretary of State, I must inform the House that I have selected the amendment in the name of the Leader of the Opposition.

The Secretary of State for Health (Mrs. Virginia Bottomley): I beg to move, That the Bill be now read a Second time.
The Bill represents the final steps in the programme of national health service reform that began with the National Health Service and Community Care Act 1990. When we embarked on those reforms, there was a clear consensus that the NHS needed to change. Despite the substantial extra funds that the Government had committed—increases unprecedented in its history—the service was still often inefficient, inflexible and unresponsive to the needs of patients.
Management was exercised through a cumbersome, command-and-control bureaucracy; staff were trapped in a system over which they had little or no control; the vested interests, whether they be the trade unions or the Sir Lancelot Spratts of this world, had too much power. The patient had little say, and even less choice.
The background to the Bill is four years in which—

Mr. William O'Brien: rose—

Mrs. Bottomley: I am sure that the hon. Gentleman wants to share reminiscences with me, as someone who was a member of the Standing Committee that debated the National Health Service and Community Care Act 1990 five years ago. However, I must make progress.
The background to the Bill is four years in which the balance of power in the NHS has changed. We have effected a fundamental and irreversible shift in favour of the patient. Before I outline the detailed provisions of the Bill, let me remind the House of some of that progress.
We said that we would devolve power and responsibility to the local level, so that decisions would be taken as close to the patients as possible. We have done that by establishing NHS trusts, by creating a new and distinct role for local health authorities, and by giving family doctors more power through fundholding.
The hon. Member for Livingston (Mr. Cook), whose dodgy predictions we always enjoy on these occasions, foretold that the trust movement would be like a bicycle with a flat tyre. Well—some bicycle, some tyre. Not 30 per cent., not 50 per cent., not 70 per cent., but 96 per cent. of hospitals and community health services are now run locally as trusts.
I am delighted to be able to inform the House that I have approved a further 13 applications from hospitals and ambulance services wishing to become trusts from next April. That will mean that not 96 but 98 per cent. of services will be in trust hands.

Mr. O'Brien: Will the Secretary of State comment on the proposals for the Yorkshire and Northern regional


health executive, which covers an area equal to that of Scotland but which will have fewer than 140 people to administer it and ensure fair treatment in hospitals? Will she consider allowing the existing Yorkshire regional health authority boundaries to remain in place, which would mean a better service for the people of the region?

Mrs. Bottomley: That is evidence of the Opposition's hypocrisy when they claim that they wish to reduce bureaucratic layers of management. We can achieve savings by reducing the number of regional health authorities and, what is more, because of the nature of the responsibilities devolved to the districts, we do not need the large command-and-control regional health authorities. The Opposition are always hankering after regional government, tiers of government and layers of officials. That is their idea of paradise, but it is not the right way forward for the health service today.
I cannot finish with the subject of trusts without offering the right hon. Member for Derby, South (Mrs. Beckett) one last opportunity to clarify her party's policy on NHS trusts. Would they stay or would they go under Labour? Will she say yes or will she say no? She recently had breakfast with David Frost, and she made a proper meal of it. I have the transcript of the programme here.
The right hon. Lady was asked whether she would keep the trusts, and she replied:
You can't simply tear the plan up and start again".
That seems perfectly clear, but, two pages further on in the transcript, she has changed her mind—
By the way"—
she added as an afterthought—
we're not talking about keeping the Trust hospitals".
She is after all thinking of tearing up the plan and starting again.
I know that, in her defence, the right hon. Lady will say that she is consulting. She told Mr. Frost that a Labour Government's first dramatic act in respect of trusts would be to do even more consulting. To be fair to her, she also said that she would "consult fast", but that is not good enough. Labour has a third health spokesman, but the party is still consulting.
I doubt that the right hon. Lady could tell us the day of the week without gathering views from the length and breadth of the Labour movement and issuing a discussion document. It has to be said that the right hon. Lady is the author of the biggest waiting time scandal in the national health service—the length of time that the public have been kept waiting for the Labour party's health policy.
I was referring to the progress made in implementing the Government's health reforms which form the backdrop to the Bill. As part of the reforms, we promised more consultants to reduce waiting times, to improve the quality of services and to cut long hours. In those three years, more than 1,000 new consultant posts were created. Thirteen thousand on-call rotas of 83 hours for junior doctors were eliminated, and in the past six months there has been a 46 per cent. reduction in the number of on-call rotas of more than 72 hours. That is real progress, which will lead to benefits for patients as well as staff.

Mrs. Jane Kennedy: Is one of the 13 national health service trusts that the Secretary of State is announcing today the proposed new trust which

is a merger between the Broadgreen hospital trust and the Royal Liverpool university hospital trust? The two NHS trusts are struggling financially, but the proposed merger offers no solution to their financial problems.
The people of Liverpool have waited a long time for a decision. They have been "consulted"—according to the Secretary of State's understanding of the word—and we are now waiting for her announcement. Will she clarify the situation?

Mrs. Bottomley: I confirm that that trust is one to which I have been able to give approval today. It will join the other trusts in providing excellent quality of care for patients. The hon. Member is particularly fortunate to live in a part of the country which, under the leadership of Sir Donald Wilson, has delivered waiting time achievements which are the envy of the country. Most of my hon. Friends think that the people of Mersey are extremely fortunate to have their health care controlled by the health service rather than by political appointments and local councils which have not had the same achievements or praise. But I do not intend to provoke Labour Members, as I have to make a great deal of progress, and I know that they want to make their own speeches.
We said that general practitioner practices would be allowed to manage their own budgets. Fundholding has proved to be one of the biggest reform success stories. Fundholders are expanding services and shaping the services that others provide in order to respond to patients' needs. They are cutting waiting times, improving the quality of services and showing others the way.
The House does not need to take only my word, or that of my hon. Friends, for it: hon. Members should consult the report released last week by the National Audit Office. It states:
There is evidence that the direct involvement of general practitioners in health care purchasing has led to improvements in the services provided for their patients and made fundholders more aware of the cost implications of their spending decisions.
By being good stewards of available resources, GPs have been able to make the resources go further and work harder for the benefit of all patients.
The report, like the independent evaluation of fundholding by Howard Glennerster before it, is further evidence that fundholding works. The report recommends that the benefits of GP involvement in purchasing should be extended to all patients. That is our policy, and it is why I recently announced a radical extension of fundholding.

Mr. Nicholas Brown: Is there not a problem with the right hon. Lady's argument? The National Audit Office report also says that, at the time of the field work, none of the regions it visited was able to compare directly the funds allocated to fundholders and the resources available to districts to purchase equivalent services for the patients of non-fundholders. In other words, the NAO says that direct comparison is not possible.

Mrs. Bottomley: It is quite clear that the methodology behind setting budgets and the details of the reforms' implementation are improving all the time.

Mr. Rhodri Morgan: Compare like with like.

Mrs. Bottomley: It is comparing like with like. The report says that there is scope for improving the


methodology behind the allocation of the budget. It also says that, as we move to capitation funding for GP fundholding, it will be more possible to make tight comparisons. There is overwhelming evidence of the benefits of GP fundholding in independent report after independent report. It is also evidenced by the number of people who are seeking to become GP fundholders, and recent Government announcements have made that even more possible.

Mr. Tim Smith: Is it not extraordinary that the Opposition will not accept the National Audit Office's genuinely objective and independent assessment of the situation? It has completely vindicated the decision to establish fundholders, as well as making the more general point about pushing down decision making in the health service as far as possible.

Mrs. Bottomley: I thank my hon. Friend for his comments. Characteristically, the Labour party has a lowest common denominator approach to everything. Labour Members dislike excellence and innovation. They think that any change must be a change for the worse, and that is a tragedy. GP fundholding has been commended by the Organisation for Economic Co-operation and Development report, by Professor Glennerster's report, and now by the National Audit Office. Labour Members are deaf and blinkered; bad news is the only news they favour.
The Government have achieved the objectives which we set out in the National Health Service and Community Care Act 1990. Trusts are here to stay, and fundholders are leading the drive towards our goal of a primary care-led health service. The power to take decisions has been put in the hands of those closest to patients.
But in one vital respect, we want to go further than was envisaged in our original reforms. The principle purpose of the Bill is the abolition of regional health authorities. The RHAs played a necessary role in the old NHS. That fact has been recognised by many of my colleagues, not least by the late Lord Joseph, to whom I pay a very warm tribute. He was a most distinguished predecessor in this office and a major contributor to the well-being of this country.
In the first stages of the reforms, regional health authorities assisted the successful development of trusts, of fundholders and of district health authorities in their new purchasing role. I express my appreciation, and that of other Ministers, of the work of regional chairmen over the years. I am pleased to say that they will have a continuing and important role as regional members of the policy board.
The successful devolution of responsibility to local level inevitably meant that the role of RHAs would reduce. To put it slightly more bluntly: they were the last bastion of the old command and control system from which we have now escaped. By abolishing RHAs, the Government will sweep away an unnecessary tier of NHS management. The Bill is part of our concerted move to streamline management, to eliminate unnecessary duplication and bureaucracy, and to save money on administration which we can then spend on patients.
We estimate that the savings from the Bill will total £150 million every year in England, and at least £3 million a year in Wales— substantial savings, which will result in even better patient care. Those savings will result from the abolition of RHAs and from bringing together

and halving the number of DHAS and family health services authorities. In Wales, 17 health authorities will be reduced to five. A further £50 million will be saved from reductions in the size of the Department of Health. We are determined to ensure that we set an example from the centre, and we expect streamlining to take place throughout the service.

Mr. Kevin Hughes: If the Secretary of State's Government are leading the fight against bureaucracy and are streamlining management, why has bureaucracy in Doncaster increased by 48 per cent since the changes were introduced? Spending on bureaucracy has increased from £4 million to £6 million—and that is only in Doncaster. Where is the Secretary of State's streamlining there?

Mrs. Bottomley: A less than worthy characteristic of the Labour party is its knee-jerk attacks on NHS managers at every possible opportunity. People who go into NHS management are committed to the national health service and to the improvement of service provision to patients.
The Government's achievements have included strengthening management in NHS trusts and health authorities; ensuring that there is better financial control, so that health authorities do not run out of money nine months into the year; and, above all, managing waiting lists so that progress can be made on waiting times. The hon. Member for Doncaster, North should realise that, because of the Government's reforms, his region has received a further £139 million this year for the benefit of patients. Those are the achievements that really matter.
In line with our manifesto commitments, substantial efficiency savings, amounting to £200 million, will be spent to improve the quality of services further. Thanks in part to this Bill, we will be able to make even further cuts in hospital waiting times.

Mr. Alex Carlile: On the question of NHS administrators, does the Secretary of State agree or disagree with the views expressed on that subject by her hon. Friend the Under-Secretary of State for Wales?

Mrs. Bottomley: I certainly agree with the Under-Secretary of State for Wales, my hon. Friend the Member for Clwyd, North-West (Mr. Richards), who makes a very important contribution to the decision-making process. It is a great asset to have a colleague in the territorial Departments who takes a close and detailed interest in the matter, and I am delighted to see that he is in the Chamber today.

Mr. Robert Banks: I am especially glad that my right hon. Friend has paid tribute to the work of employees in the regional health authorities. Will she, however, give full recognition to the talent, expertise and knowledge of the work force during the reorganisation? In particular, will she consider carefully before moving the headquarters from Harrogate, which has one of the best possible offices? If the headquarters was retained, the pool of expertise could continue its valuable work in the enlarged area.

Mrs. Bottomley: I know what a great champion of that cause my hon. Friend is. I have visited the headquarters to which he refers, and his local trust hospital. I have seen some excellent mental health project developments there. Detailed consideration is, of course, given before final


decisions are made. The region under consideration is large, so it is important to have the headquarters somewhere that is accessible not only for the area my hon. Friend represents, but for those in the north and the east of the region.

Several hon. Members: rose—

Mrs. Bottomley: I will not give way now, because many hon. Members may be fortunate enough to catch your eye later, Mr. Deputy Speaker.
In short, the changes will ensure that we have a local service which is locally accountable to health authorities and trusts providing the service, and not the great command-and-control, hierarchical, bureaucratic service of the past. It is because of that change that the service is so much more flexible and so much more responsive to local circumstances than it would be with a command-and-control system.
It is not a coincidence, of course, that Labour Members belong to the party that produced that great document, the national plan, in 1965. That is how Labour Members would like to run the health service. They would like one document in the centre—

Mr. Morgan: A Stalinist approach.

Mrs. Bottomley: Exactly—a Stalinist approach to these matters. The hon. Gentleman has helped me with the word. We believe in devolution and flexibility.

Mr. Morgan: Will the right hon. Lady give way?

Mrs. Bottomley: No. The hon. Gentleman will be able to address the House on his Stalinist ideas at great length later. He will understand that I must now make progress—[Interruption.] I will not be tempted on the matter now.
The Opposition's amendment refers to cancer services. Thanks in part to the Bill, we shall be able to make further progress on that front as well. We shall build on the excellent cervical and breast screening programme that we established. I again place on record my commitment to take forward the principles set out in the report on cancer by the chief medical officer's expert advisory group. I want to see them sensibly implemented throughout the service. Facing changes, as we do in the Bill, will enable us to do precisely that.
This is the difference between the Government and the Opposition. Labour's policies are in turmoil, and its policies threaten turmoil for the national health service. We have introduced this sensible measure, which will improve the management of the NHS, improve its efficiency and improve services for patients. Let no one be in any doubt that, if the Opposition vote against the Bill tonight, they will be voting for bureaucracy and inefficiency, and voting to put patients last.
I turn now to the detailed provisions of the Bill. It is essentially a straightforward measure, with one major provision in clause 1, which will abolish regional health authorities. It will also remove the existing district and family health services authorities and replace them with a single body—the health authority.
It is a further measure of the success of the reforms that the merger of DHAs and FHSAs now seems an obvious and inevitable step. Many DHAs and FHSAs already work in an integrated way under a single chief executive.

Those joint health commissions eagerly await formal merger and other authorities are not far behind. It has become clear that the whole NHS will be ready for this change by 1 April 1996. We have decided, therefore, to establish all the new health authorities on the same date. That will make it absolutely clear where we stand and where the future lies.
As all hon. Members are probably aware from their constituency mail, many people outside the health service cannot tell the difference between DHAs, FHSAs and RHAs. I am pleased to tell them that they will not have to bother in future. From 1 April 1996, there will be just one health authority at local level, and the system will be simple, clear and accessible. The new merged authorities with their wide span of responsibility will have real influence at local level.

Mr. David Hinchliffe: We suggested that.

Mrs. Bottomley: I am delighted that the hon. Gentleman is prepared to offer advice to the Government on these matters. I know that he will vigorously support the legislation when it is in Committee. My hon. Friend the Minister for Health has noted the hon. Gentleman's enthusiastic support; he may be able to help to move some of the amendments.
The local authorities will have real influence and a vital role. They will be the single authority responsible for ensuring that the entire health needs of their populations are met. For the first time, their job will to be to ensure that the hospital, the community and the family doctor services are planned together in a coherent and co-ordinated way. I expect the new health authorities to work especially closely with the family doctors in their areas—fundholders and non-fundholders alike.
General practitioners, as my hon. Friends are well aware, have always had a crucial role as the gatekeepers of the national health service. Their position is a hallmark of our health service and is recognised, at home and abroad, as one of its great strengths. Our reforms have, rightly, enhanced the role of family doctors. We have given them new powers and new authority to shape services according to the needs of patients. The Bill will build on that.
The Bill will ensure that family doctors are even more at the heart of the new NHS. The new health authorities will be better placed to support GPs in the move towards more primary care-led health care, and they will ensure that family doctors, as the National Audit Office report again suggested, are fully involved in the crucial task of purchasing secondary care.
Schedule 1 makes the consequential changes required to reallocate functions. The new health authorities will bring together responsibility for both primary and secondary care—[HON. MEMBERS: "And dentists."] Indeed, as hon. Members say, dentists will also be included. As a result, the new authorities will be able to take on some of the roles previously carried out at regional level.
We shall be able, for example, to pass down to local level functions such as purchasing specialist services, public health, midwifery supervision and some aspects of education and training. Where tasks need a wider perspective than a single health authority, several will be able to work together, supported as necessary by regional offices. I know that this is a point of concern to many of


my hon. Friends. The new system will retain the necessary overview to ensure that the health service continues to deliver its objectives efficiently, effectively and coherently.
We have today published a guide to the operation of the new system, which sets out some of the issues in more detail. It builds on good practice and experience so far. Among other things, it describes the role of the new regional offices. The proper implementation of key national policies, such as our objectives in "The Health of the Nation", the reduction of junior doctors' hours, teaching and research, and the development of regional and supra-regional specialty services, requires strategic direction. The NHS executive, operating through its regional offices, will discharge that role. It will support the development of local policies and, where necessary, ensure effective co-operation across service, education and research.

Mr. Hugh Bayley: The Secretary of State referred to the Yorkshire regional health authority office in Harrogate. Will she undertake to publish the full and detailed option appraisal on whether the new regional offices should be based in Harrogate, York or Durham, so that hon. Members within the new region can express opinions on the merits of each case and so that the public can be consulted? Or does she intend that the new decentralised health service should deny the public the opportunity to express views on the health service? Will decisions simply be taken behind closed doors in the NHS executive?

Mrs. Bottomley: I regret having given way to the hon. Gentleman. It is the case that decisions about the delivery of services are open to public consultation, and the papers are made available. For decisions about the organisation of NHS staff and people in the Department of Health, that is not the process followed. Our duty is to ensure that the taxpayer's money is used as effectively and efficiently as possible for patient services.
I regret giving way to the hon. Member for York (Mr. Bayley). I thought that he might have something interesting to say about the role of the regional office and that vital aspect of delivering a local service but also managing to pursue a number of national priorities. We believe that we have got that balance right in this important Bill—through detailed consultations and consideration within the service.

Mr. D. N. Campbell-Savours: rose—

Mrs. Bottomley: I have lost patience. I was so disappointed with the comments of the hon. Member for York that I am not prepared to give way. I am afraid that my patience has withered away. I shall try to be more forgiving in due course, but now I have lost patience.

Dame Elaine Kellett-Bowman: Do not give way.

Mrs. Bottomley: I am deeply in awe of my hon. Friend, and will follow her instructions.
What matters is to establish a more effective, streamlined management, so that the executive can better fulfil its role. That will ensure that we continue to deliver national policies by getting the best out of the local flexibilities that are at the heart of the new NHS.
The regional offices will not be RHAs by another name, however. They will be considerably smaller, and totally different in outlook. Two years ago, the regions employed around 3,900 staff. Today they employ 2,600. The new regional offices will employ no more than 1,100, which is less than a third of that original size.
Their work will focus on the key functions that have to be exercised at regional level. There will be no unnecessary duplication of functions between the regions and the centre, or between the regions and NHS trusts and health authorities. The executive will give proper strategic management to ensure accountability of health authorities, fundholders and trusts. The simplified structure means that information and advice can flow more freely between the NHS executive and local level. There will be a clear line of accountability from the NHS in the field through to Ministers.
The new system will further promote freedoms at a local level. It recognises the importance of innovation and will nurture it. We utterly reject the Labour party's model of a health service—rigid, monolithic and crawling along at the pace of the slowest. We believe in the rest learning from the best and in levelling up, not levelling down. That is the culture that the Bill will reinforce.
I do not need to take the House through the functions in schedule 1 in detail, as most of them are straightforward consequential amendments, but I must highlight two areas, not least because they are of direct relevance to the Labour party's amendments. They are the role of professionals and the future of education and research.
On the latter, we are committed to maintaining and improving the essential partnership between the universities and the NHS. I have already had productive discussions with the Committee of Vice-Chancellors and Principals, and we will monitor progress carefully during and after the reorganisation.

Dame Elaine Kellett-Bowman: I trust that my right hon. Friend is not referring only to universities, as there is a very good Project 2000 in St. Martin's college in my constituency, which is not a university, although it is as good as most, or better.

Mrs. Bottomley: Again, my hon. Friend has the right of it. She will know that that revolution in the training of nurses is one of the changes since the introduction of the reforms. The Project 2000 course is now available throughout the country. As my hon. Friend rightly says, we are leading in that area. The courses are especially good for training nurses to work in the community as well as in a hospital setting. I thank my hon. Friend for drawing that fact to the attention of the House.
As I think that my hon. Friend the Member for Lancaster (Dame E. Kellet-Bowman) will agree, the training of doctors and dentists has certain special aspects—the long training, the rotations and the links with research. Because of the importance of maintaining those contacts, I asked the eight regional policy board members to take special responsibility there.
Some of the changes that the Bill introduces are to enable consortia of health authorities and trusts to work more closely together in informing the purchasing of education and training over time and, in due course, taking on some purchasing themselves. That will no doubt apply to the college to which my hon. Friend referred. That change will take place within a national framework, which will be carefully overseen by the NHS executive.
Similarly, because medical research in this country is, frankly, outstanding—some of our centres receive commendations from around the world—it is important that we have the right balance between local and national input. Many of my hon. Friends will be aware of the important work undertaken by Professor Michael Peckham, the first ever director of research and development for the NHS.
I was recently able to underline the Government's commitment to teaching and research by announcing an additional £40 million support in the coming year. In passing, it is only possible to make such announcements for the health service because the Government are taking such good care of the economy that we have such sums to invest.
Following the publication of the detailed document "RD in the New NHS" and of the important Culyer report, we have been holding discussions with the research and academic communities, with a view to introducing a new single stream of funding for NHS research. I am pleased that, so far, that has been welcomed. I shall be able to make more announcements shortly.
Finally, when we make regulations on the membership of the new health authorities, we will require them, where they have a medical or dental school in their area, to have a university member on the board. In doing so, we shall continue the present arrangements, which recognise how vital is the partnership between universities, medical schools and the NHS.
On health authority membership, when our changes created district health authorities, with their new and distinct role, we paid special attention to who should sit on their boards. Frankly, I regret the fact that so many of the non-executive members have had to face the vituperation of the Opposition, who constantly denigrate their contribution, regardless of the way in which appointments to health authorities were made by the Labour party when it was in power, and of the arbitrary way in which 32 health authority chairmen were dismissed at one stroke by a former Labour Secretary of State for Health because he did not like their political colour.
More important than the non-executive appointments, however, we brought in executives for the first time. It was absurd that, under the old system, the agenda was often dominated by overtly political interests, such as the prospective local Labour party candidates in Greenwich who sat on the board of the health authority, while those who had to do the work had to sit on the sidelines. In the new health authorities, we propose that the executive members will include a director of public health. The Labour party's amendment—characteristically missing the point—mentions regional public health directors.
Of course, the new local health authorities should be the focus of action in a decentralised system. The public health function should properly reside there, closer to the public whose health is the key issue. That is why, in an important advance on the old system, we will establish for the first time as a statutory requirement an executive director of public health at the local level.
Health authorities will continue to be unified boards, bringing together executive and non-executive members working towards a common purpose. It is important that

they comprise the best people locally to give them the balance of skills that they need. People should be selected for the personal qualities they bring to the boards, and not to represent sectional interests. As the House will know, we are opening up our appointments procedures so that both health authorities and trusts have access to an even wider range of skills and experience.
I have asked the right hon. Member for Derby, South before to take her embargo off the trusts and to encourage people to serve on them, instead of putting them in the appalling position in which, if they serve on trusts, they are apparently supposed to be working for her to bring them to an end.

Mrs. Margaret Beckett: I must have told the right hon. Lady at least three times that there is no such embargo. Will she cease making such a silly point?

Mrs. Bottomley: I am to some extent reassured by the right hon. Lady's comments, but members of her party have been worried about taking on such appointments, when approached to do so by Ministers, because of their fears of offending the party they support. If that happens again, I shall refer the details to the right hon. Lady.
The Bill will build on the practice that we have already established with district health authorities, so that the new boards have the best people to help them to discharge their vital role.
We expect that a growing number of both health authority and trust members will have backgrounds in nursing, medicine or any other relevant profession, and we are already seeing examples of that.
The hon. Member for Wakefield (Mr. Hinchliffe) and I served on the Standing Committee on the National Health Service and Community Care Act a long time ago—[Interruption.] We were all young then. The hon. Gentleman, and my hon. Friends who served on the Committee, will be aware that the president of the Royal College of Physicians at that time was Dame Margaret Turner-Warwick. I am pleased to report to the House that she has for some time contributed her considerable talent as chairman of the Royal Devon and Exeter trust.
I am delighted to be able to announce today that the then chairman of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting, Dame Audrey Emerton, is now to take up her post as chairman of the Brighton hospitals trust. I think that that is very good news indeed.
Sitting on boards is not the only way for professionals to be involved, nor is it sufficient. I commend to the House the views of Professor Cyril Chantler, who is principal of the United Medical and Dental Schools of Guy's and St Thomas's, and is a policy board member. He described the old medical advisory committees as
functioning as a sort of Greek chorus, commenting on what was going on the stage but not taking part in the play.
He says that doctors need to contribute to
the strategic and operational management of the service, in hospital, in the community and in practice, and in the commissioning role at district and central level, rather than doctors simply seeing themselves as there to give advice.
I strongly agree, although I would extend the analysis to nurses, dentists, pharmacists and the full range of health professionals.
As Professor Chantler suggests, the existing professional advisory structure is not firmly integrated into the work of regional and district health authorities. It


is peripheral, and that is why we will not be incorporating it into the new structure. We want professional advice to be integral in the new structure, and we want professional advice to become professional involvement. We require the new health authorities to promote a constructive partnership between health professionals and managers, as many of the best DHAs and family health service authorities are doing.
Teamwork is vital to the NHS, and I have been at great pains to point that out during my tour of the regions during the past six months. The Bill will make teamwork easier by removing some of the organisational boundaries, and enabling us to build on the considerable progress which has been made during the past four years.
The House will want me to address the question of accountability. There will be a full and accountable partnership between health authorities and the public on whose behalf they act. The Bill marks an important boost for accountability by cementing the devolution of decision-making to local level. The closer to patients that decisions are taken the more accountable the service will be to them. Health authorities are beginning to work much harder at explaining to the public what they do, and asking how they could do better.
I believe that they could be doing better still, and I shall insist that they do so. In the new structure, the public will have access to a single body which will be responsible for securing health care for them. The new authorities must work even more closely with the public—consulting, communicating and involving them in key decisions.

Mr. Campbell-Savours: As a Member who is sponsored by Unison—the union pays me personally nothing, in case the Secretary of State wishes to misrepresent that fact—may I press her on the question raised by my hon. Friend the Member for York (Mr. Bayley) about a very important issue for the northern region? Why cannot we, and the health service workers and administrators throughout the region, have access to the appraisal documents which were produced in conjunction with departmental officials upon which the decision to move the regional headquarters has been taken?
Is it not significant that, when the hon. Member for Harrogate (Mr. Banks) intervened, he did not ask that pertinent question? He asked a safe question, which he knew the Secretary of State could answer.

Mrs. Bottomley: My hon. Friend may wish to raise that point in his own speech. I have made the position clear. There is a requirement for consultation when there is a proposal to change services for patients. As many hon. Members will know, that consultation can be extremely lengthy and often delays necessary change, but it is important in terms of changing services for patients. Ministers have a duty to make sure that taxpayers' money is effectively used, and the streamlining outlined in the changes will result in better patient care. The hon. Member for Workington (Mr. Campbell-Savours) will know that another £139 million will go to his region in the year ahead. The changes will mean that we can do even more.
I was talking about the important role of the new health authorities in making sure that they involve local people in decisions. Authorities must consult and encourage local visibility. We are making much more information about the organisation of the service available to the public than

ever before through annual reports, public meetings and the important NHS performance tables. None of that information was ever made available to the public when the Labour party was in power.
That is the accountability that matters to patients—information which enables them, or their advocates, the GPs, to exercise informed choices. We shall back all that up through clear lines of accountability between the NHS at local level and Ministers. Those lines will be reinforced by such measures as our codes of conduct of accountability and openness.
Let me briefly mention clause 3 and schedule 2, which provide for the transition to the new structure. Clause 3 gives health authorities wide powers to work together, so that, by 1 April 1996, they can be completely ready for merger. We are taking steps to manage the process effectively to minimise any disruption to services. The significant degree of joint working which is already in place will help, and some of my hon. Friends have referred to that.
Schedule 2 provides for the effective reallocation of the staff, property, rights and liabilities of the authorities which are being abolished. We will do all we can to minimise the distress to health authority staff. I take the points made by my hon. Friend the Member for Harrogate and by the hon. Member for Workington—[Interruption.] The hon. Member for Workington, having made his intervention, is no longer interested. He talks about being interested in staff, but when I talk about minimising the disruption to staff, he cannot even be bothered to listen. [Interruption.]

Mrs. Beckett: Is it not rather bad parliamentary manners for the Secretary of State to chide my hon. Friend for not listening when the hon. Member for Harrogate—to whom she referred—is not even in the Chamber?

Mrs. Bottomley: The hon. Member for Workington was talking through my speech. That is a great discourtesy, particularly when the hon. Gentleman protests his interest in health service staff. But that will not surprise any of my hon. Friends at all, and I only regret giving way to the hon. Gentleman.

Mr. Campbell-Savours: The hon. Member for Leicestershire, North-West (Mr. Ashby) is fast asleep.

Mrs. Bottomley: My hon. Friend did not intervene during my speech. The hon. Gentleman persistently made attempts to intervene, and he has proceeded to have his own conversation while I am discussing what we are doing for health service staff. I shall move on, as clearly we will have some fascinating speeches from Opposition Members, and certainly my hon. Friends are longing to get in.
I began by setting out the background to the Bill, and the enormous progress which has been made in a short time in implementing the health reforms. What is truly remarkable is that, throughout the period of substantial organisational change, the NHS has not only maintained its services to patients, but improved and enhanced them.
For every 100 patients treated in 1990-91—the last year before the reforms—118 were treated in 1993-94. [Interruption.] I find it extraordinary that Opposition Members cannot be bothered to listen to the staggering achievements of Health Service staff during the process of transition. I suppose—as ever—that the news is so


good they cannot bear it. In 1994, we expect the number of patients treated to rise to 122 for every 100 treated before the reforms.
Whereas, before the reforms, 170,000 patients were waiting for more than one year, today that figure is just 60,000, and it is coming down. The figures which have been published only today show that, in the past five years, the number of hip replacement operations has risen by nearly one quarter, the number of cataract operations by 44 per cent., and the number of heart operations by 65 per cent. Those are impressive figures, and they mean an improved quality of life for many thousands of people.
While the implementation of the reforms has been a substantial management success, the changes should only ever be seen as a means to an end, and not an end in themselves. The real challenge lies in realising the full potential of the new NHS at a time when it must respond to profound changes in clinical practice, the aging of the population and the rising expectations of patients. Those changes have been recognised not least by the medical profession in its recent welcome statement on core values.
The measures contained in the Bill will draw our organisational changes to a successful conclusion. They are based on our experience so far, and on evolving practice. They reflect widespread consideration and discussion within the service and beyond. They provide the basis for a period of stability and constructive partnership. They will streamline and improve management; cut bureaucracy and costs; and ensure that even more power and responsibility is passed down to where it belongs—to those closest to the interests of patients.
The independent evidence that our reforms are working is mounting up. The OECD, the Audit Commission, the National Audit Office, the British social attitudes survey, and independent experts of all persuasions and none, say that the Government are getting it right.
The Bill is important and timely, and a good one. It confirms our commitment to a comprehensive, high-quality health service, which responds to the needs of patients and is true to its founding principles. It puts in place the final building block to create the first-class health service we need, fit for the 21st century. I commend the Bill to the House.

Mrs. Margaret Beckett: I beg to move, To leave out from 'That' to the end of the Question, and to add instead thereof:
this House declines to give a second reading to the Health Authorities Bill; notes widespread concern over future provision of cancer screening services, the independence of regional public health directors and the delivery of medical education for doctors; fears that claims for reduced bureaucracy and savings to public funds will prove ill-founded; and believes that far from completing the NHS reforms the Bill fails to address the problems of hospital closures, waiting lists over one million, commercialisation of trusts, a two tier service with general practitioner fundholding and the fragmentation of a National Health Service into hundreds of health businesses.
I salute the extraordinary efforts of the staff of the national health service to maintain the level of that service in the face of the Government's enthusiasm for the anarchy of the internal market, the fragmentation of the service and the commercialisation of health provision. I

make that point deliberately at the outset of my speech because I have observed from previous debates that if the Opposition do not mention what a wonderful job the staff of the NHS are doing the Secretary of State accuses us of attacking them and not appreciating their work in the public service.
Let it be clearly on record that the Labour party believes that the ancillary workers, nurses, dentists, physiotherapists, dieticians, cleaners, radiographers, radiologists, doctors, anaesthetists, consultants, clerical workers, managers and physicists—to name but some of the categories of staff—are unstinting in their loyalty to the health service and to the notion of public service.

Mr. Keith Mans: What about Ministers?

Mrs. Beckett: No, definitely not the Ministers.
Let our admiration for the level of patient care that is still provided in the health service be clearly and explicitly on the record. And let it be accompanied by an equally explicit and clear statement that it is, remains and always will be our view that the NHS is a public service which should not be—and by the Labour party never will be—regarded as a business.
It should not be necessary to detain the House by making such relatively simple statements about our support either for staff or for patients. I do so only because the Secretary of State has developed a rather tedious habit: if the Opposition fail to mention the staff of the health service, the right hon. Lady accuses us of attacking them and not appreciating their work. Yet if we mention them, she accuses us of being in the pockets of the trade unions. That is scarcely a sophisticated debating technique, and it has become deeply boring; as we are discussing a new Bill, I urge the right hon. Lady to turn over a new leaf and just drop it.

Mr. Gary Streeter: Will the right hon. Lady give way?

Mrs. Beckett: On that point, by all means.

Mr. Streeter: Will the right hon. Lady make one further thing clear today? Would the Labour party abolish NHS trusts—yes or no?

Mrs. Beckett: We have made it clear repeatedly that we certainly do not intend to work with the current structure of NHS trusts, but we are exploring how to knit those trusts—

Mr. Streeter: So the Labour party will abolish them?

Mrs. Beckett: What does the hon. Gentleman mean by "abolish"? Those trusts exist, and the hospitals and services that they run exist; of course we do not want to get rid of those services—no one does. If the hon. Gentleman is asking me whether we intend to continue with the structure of those individual health businesses, as set up by the Government, the answer is most certainly not—everyone is aware of that.
What causes huge resentment in the House and widely outside is the Government's attempt to outlaw the questioning and criticism of their policies towards the health service by insisting that anyone who attacks those policies is attacking the service itself. Let me, once again, put it clearly on the record that the Opposition are not attacking the health service, whether that means the staff, the patients or anyone else involved in its efficient


operation. We are, however, attacking what the Government are doing to the health service and we have not the slightest intention of being deflected from that attack.
Part of the problem is that the health service is under attack—from the Government. In particular, all the staff who work in the health service, at every level, are under attack because the Government are attacking them. They are under attack by threats that their pay will be linked to their individual performance. They are also under attack because that performance will obviously be measured, at least partly, against the yardstick of loyalty to the organisation and the extent to which staff are prepared, as they were recently urged by one of the Secretary of State's most loyal supporters, to put the interests of the organisation before the interests of the patient.
They are under attack because, should they dare to speak out about their concerns and anxieties in relation to patient care, their very livelihood is threatened by the new gagging contracts issued by so many of the trusts which have been set up by the Government's legislative changes. Finally, and perhaps most insidiously of all, staff feel themselves to be under attack when they hear people like Professor Caines say that the very notion of public service is at an end, when it was exactly to engage in the service of the public that most of them joined the health service in the first place, and they still take pride in that concept.
The Secretary of State is seeking wide powers in the Bill—in many cases, wider powers than those available to previous Secretaries of State through earlier legislation under Governments of every political shade. Much of the detail of what is intended to be done with those powers is left unstated in the Bill. Yet again, we are witnessing sweeping enabling legislation from the Government, with an immense amount of the detail and execution of it left to regulations which, of course, cannot be amended. We are greatly concerned about that aspect of the Bill and we shall seek to explore it in Committee.
One thing that is clear from the Bill and the schedules to it is that, apart from taking substantial powers, the Secretary of State seems potentially to be removing from the arena others who might possibly have a different point of view or a different perspective to express. For instance, I was surprised as well as dismayed to see that the Government intend to abolish local advisory committees. According to another proposal in the Bill—exactly the type that will cause public concern—in future when a local hospital is thinking of applying for trust status, consultation—which in the past had been compulsory—will be carried out only if the Secretary of State thinks that is necessary, and then under terms that the right hon. Lady will decide sometime between now and when the regulations are published. The Bill contains no suggestion as to what those criteria might be.
One thing that I should have thought that everyone in the House had learnt, at least from the experience of the workings of the Child Support Agency, is just how dangerous it is to leave all the detail—the framework of proposals—to regulations rather than just matters such as exact figures or precise dates, which have always been properly matters for regulation.
I listened with care to what the Secretary of State eventually said about the Bill. There are elements in it to which we can offer support—in particular, the proposal that district health authorities and family health services authorities should be merged. As my hon. Friends pointed

out in sedentary interventions, the Labour party has long advocated that. Like the Government, we believe that such a merger could and should lead to more efficient management of resources, better planning and ultimately a better service for patients. We shall look forward to exploring in Committee the detailed implementation of that proposal.
That proposal, however, sits alongside the proposed abolition of regional health authorities. The removal of some functions from regional level and the apparent intention to devolve them to local level is a matter of concern not only to the Opposition but to people throughout the health service. We shall want to explore that issue, too.
As I am sure that the Secretary of State must be aware, widespread anxiety has been expressed about the loss from regional level of the maintenance of cancer registries or the handling of national confidential inquiries. However, the main matter that I shall first discuss is the Secretary of State's claim that those proposals and that aspect of the Bill are not merely part of the Government's so-called reforms of the health service, but a necessary part of completing the process of reorganisation.
It seems to us that that specific proposal is neither necessary nor desirable, and it leads us to have grave doubts about the real intentions behind that part of the Bill. We treat with considerable cynicism the Secretary of State's assertion that the changes that she proposes will automatically lead to improvements in patient care.
The Government appear to be managing the operation of the national health service with the same level of competence that they apply to managing the Conservative party. Indeed, if the Government were a privatised trust and not a publicly financed, publicly accountable, publicly run Administration they would definitely be in severe difficulty. Their public relations consultant, Mr. John Maples, has just advised them that the British electorate are unwilling to renew their contracts and that they, the Conservatives, can never win on that issue. In consequence, he advises:
The best result for the next 12 months would be zero media coverage of the National Health Service"—
not the best result for the national health service, but the best result for the interests of the Conservative party, to which alone the Government's concern appears to be directed.

Mrs. Virginia Bottomley: Will the right hon. Lady give way?

Mrs. Beckett: I am delighted to give way to the Secretary of State on the subject of the interests of the Conservative party.

Mrs. Bottomley: The right hon. Lady's account is bizarre. As I told the House this afternoon, in five years there has been a 65 per cent. increase in heart operations, a 44 per cent. increase in cataract operations and a 24 per cent. increase in hip operations. Those are dramatic achievements. The number of patients being treated now—

Mr. Morgan: What was the increase in the previous five years?

Mrs. Bottomley: I can tell the hon. Gentleman that the increase in activity during the 1970s, when the Labour party was in power, was about 1 per cent. a year. The


increase in activity throughout the 1980s was about 2.5 per cent. a year. Since our reforms, the NHS has been increasing the number of patients treated by about 5 per cent. a year. It is a much better, more efficient service, delivering much better quality.

Mr. Deputy Speaker (Mr. Geoffrey Lofthouse): Order. I address these remarks not just to the Secretary of State but to everyone in the House. This afternoon it seems that the interventions have been speeches and not to the point. In future, let us have interventions to the point and on the subject in question. [Interruption.] Order. I was directing my remarks not only to the Secretary of State but to everyone in the House.

Mrs. Beckett: The Secretary of State tells us, as she did in her speech, about some of the achievements of the national health service. However, she was selective in the figures that she gave, quoting areas in which new technology is coming into play as well as changes in the manner of treatment. It is not at all clear to me that the figures that she gave my hon. Friend the Member for Cardiff, West (Mr. Morgan) were for a comparable area of health care, but never mind—we are used to Ministers not giving accurate figures in the House or, indeed, anywhere else.
Although the Secretary of State highlights some of the genuine achievements of the staff of the health service and the development of health care, not only Labour Members but people throughout the country resent the Government claiming credit for those improvements, as though they all flow from the Government's reforms and changes. In fact, they have absolutely nothing to do with the Government's reforms and changes. Indeed, in many cases, those changes have seriously impeded the development of better health care, as everyone in the country recognises, except those on the Conservative Benches.
The Conservatives are seeking to avoid media coverage for the national health service, and if they were an organisation like a national health service trust they would be in serious trouble. Their professional team cannot be relied on any longer. As a result of a revolt last week by junior members of the team, senior board members found themselves unable to raise the finance necessary to run the business of Government. No private company worth its salt would survive in the marketplace after such a debacle. I suppose that, if the Government were not a public undertaking—if they had been privatised—we would expect them to do what Mr. Cedric Brown did recently and choose the moment of the lowest public esteem to award themselves a 75 per cent. pay increase, or at least something substantial.
The Secretary of State says that the Bill will complete the reforms that were begun in 1990. The phrase has a neat, tidy and finished feel, as though she were a ship's steward, conscientiously dashing about, reordering and rearranging the deckchairs on—no, not the Titanic on this occasion, but perhaps the Achille Lauro. The impression created by the Secretary of State's public statement, which she sought to reinforce in her intervention a few moments ago, is that soon everything will be satisfactorily completed and after her spate of demented and feverish

activity she will be able to sit back and relax in her deckchair as the national health service liner continues on its voyage.
The reality, of course, is quite different. Like the Achille Lauro, the national health service has sunk—and public confidence in the Secretary of State's captaincy at the Department of Health has gone down with it, just as public confidence in the Government has descended to the depths. Contrary to the cheery picture that the Secretary of State tries to paint of the tidy, scrubbed deck of a floating national health service, all that we see are survivors trying to cope in the 485 separate leaky lifeboats of the individual health businesses that are the real result of the Secretary of State's reforms.
The Secretary of State asked why we were criticising the performance of the health service under her administration, and talked about all the improvements that she detects and the figures that she gives for specific operations. One of the reasons why we take what the Secretary of State says not with a pinch but with a bag of salt is that scarcely a day goes by without an NHS survivor contacting my office and the offices of my Opposition colleagues, alerting us to yet further deterioration in the service as they experience it.

Mr. Tim Smith: "It wasn't like that under the last Labour Government."

Mrs. Beckett: The hon. Gentleman is exactly right. That is exactly what they say on every occasion—"The health service is nothing like it was. Our health service is disappearing before our very eyes and we bitterly resent the speeches of Conservative Members who do not seem to understand what is happening in our health service." That is what they all say.

Mr. Smith: My experience is that complaints about the NHS were never greater than in 1976, 1977 and 1978, when the Labour Government cut capital expenditure on hospital buildings by 20 per cent. In comparison, there are very few complaints today.

Mrs. Beckett: I can only tell the hon. Gentleman that none of the people who have telephoned my office so far have been aged less than 18. They are all people who experienced the national health service and were treated by the national health service in the days that the hon. Gentleman is talking about. They all say what everyone except the Conservative party says—that the NHS is worse than it used to be, and that they are deeply upset and worried about the way that it is disappearing before their eyes.

Mr. Campbell-Savours: As my right hon. Friend knows, I have been in hospital for some fairly long periods in the past couple of years, and it is interesting that, every time that I have been in hospital—sometimes for as long as three weeks—nurses, doctors, consultants and administrators have always come to my bed when they learned that I was a Member of Parliament, to tell me how worried they were about developments in the national health service. How can the Government possibly deny it?

Mrs. Beckett: My hon. Friend is entirely right, and he knows that his experience is shared by every Opposition Member. I find it extremely difficult to believe that people avoid saying the things to Conservative Members that they say to every Opposition Member.
I will give some further examples of reasons why we express anxiety—to which the Secretary of State seems to take such exception—about the service that is provided. Three thousand seven hundred operations were cancelled on or after the day of admission in the three months between July and September in London and the south-east alone. Recently, the surgical directorate at Whittington hospital in London decided to cancel all—yes, all—non-urgent surgery except for patients of GP fundholders. In Staffordshire last week, eight out of 11 consultants cast a vote of no confidence in the chief executive at the Foundation trust. A study carried out in Britain, France, Canada and the United States showed that British doctors were the most overworked, half of them wanted to practise abroad and one third wished that they had chosen another career.
Senior hospital doctors recently made a statement about the "disintegration" of the health service—their word, not mine—and drew attention to what they saw as the distortion of clinical priorities. They said that, although patients should, as the public expect, be treated on the grounds of clinical need and priorities and their sickness, rather than the finances of the trust, that was ceasing to happen. They alleged that patients of fundholders were being treated preferentially and that non-urgent patients were taken from long waiting lists at the expense of urgent patients, who then had to wait longer. That was all being done for financial reasons—to keep hospitals solvent—rather than for reasons of medical priority. In addition, it was being done at the direction of managers because of financial concerns rather than on the basis of clinical decisions made by the medical profession.

Mr. John Gunnell: I thank my right hon. Friend for giving way. I will illustrate the point that she has just made. One of my constituents had his operation stopped after he had received the anaesthetic and was waiting outside the theatre. It turned out that the operation had been stopped on the direction of the hospital administration because of the overtime that would be involved if it were completed.

Mrs. Beckett: I just do not believe that no Conservative Members are told similar stories or are aware of similar concerns.

Lady Olga Maitland: rose—

Mrs. Beckett: I admit that I might well believe it of the hon. Lady.

Lady Olga Maitland: Surely it is time to balance the debate. Is the right hon. Lady aware that whenever I meet constituents they tell me how much they appreciate the treatment that they receive in our local NHS hospital trust of St. Helier? They say how much they appreciate the dedication of the doctors and nurses, and the speed of delivery of treatment. Does the right hon. Lady agree that, as a result of health service reforms, 3,000 more patients a day are treated than before? Surely that is something of which to be proud.

Mrs. Beckett: First, that is not the result of the health service reforms. Secondly, as the hon. Lady must be well aware, those figures are nonsense. We are talking about finished consultant episodes, not people. All that the British public care about is when people are treated, the length of time that they have to wait and how their concerns are handled. Of course we are well aware of the

dedication of national health service staff. In the hope of preventing questions such as those asked by the hon. Lady, I went out of my way at the outset to make it plain that we do not question that dedication.
I was speaking about the concern of senior hospital doctors at some of the changes they see. I am sure that the Government and Conservative Members must be well aware that it is not only those doctors who are concerned, but every patient who uses the health service and who objects to the outcome of care being determined not by the medical profession on grounds of clinical need, but as a result of Government policies. As well as the more general reports of what is happening, my office is contacted daily by people expressing fear and anxiety as a result of their personal experience of how the health service works today.

The Minister for Health (Mr. Gerald Malone): My right hon. Friend the Secretary of State is the only person in the debate so far to have given statistics about what is happening in the service and improved patient care. The right hon. Member for Derby, South (Mrs. Beckett) has relied on nothing other than anecdote. When will she provide facts? When will she make anything other than general assertions that the facts that we are providing about the health service and improved care are wrong? When will she say, in detail, why they are wrong, rather than simply making allegations? It would be extremely helpful to the debate if we could have no more anecdotes and a few facts.

Mrs. Beckett: I do not know what all that was about. The Secretary of State gives statistics about details of operations. What is the Minister of State asking for—alternative statistics? He knows perfectly well that there is widespread concern about the validity of the Government's statistics—everyone knows that. At the last Department of Health Question Time a Minister admitted that the Government's figures do not count people, but episodes of treatment.

Mr. Malone: We all know that.

Mrs. Beckett: The Minister of State says that we all know that. I rest my case and propose to go on with my speech.

Mr. Malone: There is no point in the right hon. Lady trying to be astonished about things that are well known facts. Of course such statistics are counted in completed consultant episodes—that has been the basis on which treatments have been considered for some time. On that basis, it has been shown that treatments have increased by a record number. The right hon. Lady cannot get away with trying to say that that is an astonishing revelation—it is well known.

Mrs. Beckett: I am delighted that the Minister of State has put that even more firmly on the record. It is certainly the Opposition's understanding that for a considerable time Ministers have sought to cloud the issue. When the hon. Member for Sutton and Cheam (Lady Olga Maitland) spoke a few moments ago, she talked of people being treated and said that the number of people who had been treated had increased. But the figures that she was quoting did not relate to people, but to finished consultant episodes. We are pleased to have it on record that those


are well known facts. I hope that Ministers will not trot out such statistics as proof of how many people have been treated in future.
The Minister of State mentioned levels of throughput. We are seeing changes in the method of delivery of health care, including new technology—everyone recognises that. But not one jot or tittle of the credit for any of that belongs to the Conservatives. It belongs to staff in the national health service and developments in medical technology. The attempts of Conservative Members to take the credit for it offends not only the Opposition but the general public.
The conflict between managers and clinicians is growing. There are increasingly regular reports of clinicians declaring their lack of confidence in the chief executive of their trust. Nothing in the Bill changes those concerns. On the contrary, it further centralises bureaucracy in the health service and further concentrates power in the hands of the Secretary of State. Waiting lists are still at record levels. Hospital in-patient waiting lists still stand at more than 1 million. We all know—I hope that this, too, will soon become an uncontested fact—about the many people who are not on waiting lists as they are yet to have their first out-patient appointment, but who are none the less waiting for treatment. Nothing in the Bill will assist them in their plight. Instead, the Bill's effect will be to withhold still further information from the public as regional staff become civil servants, bound by the Official Secrets Act and responsible only to the Secretary of State.
There is nothing in the Bill to address the number of complaints about the NHS. The Minister of State asked how we could raise certain issues without giving statistics, so I will give him this one: complaints about the health service rose by 57 per cent. between 1991 and 1993—so much for the Conservative party's contention that everyone is perfectly content with the progress of the service. The Bill does not respond to any of the issues. It responds to a different set of demands and a different agenda. We have seen the commercialisation and fragmentation of the health service and are now seeing the drive to introduce competition at all costs when it is co-operation in the provision of a public service that the public and staff wish to see.
There was an interesting report in the Health Service Journal at the end of last week suggesting that guidelines to be issued soon by the NHS executive would take a harder line. It said Ministers would take a harder line on the internal market and seek to
clamp down on 'anti-competitive developments' such as hospital mergers.
The article continued:
Contrary to the softer official line adopted in recent months, the guidelines reassert the efficiency gains which can be generated by competition".
In fairness, the article also stated that
Minimum intervention to protect the interests of patients" might occur from time to time. But the public want co-operation in the provision of health care.
It seems that the ultimate agenda is the privatisation of the national health service in so far as it can be said that that has not already taken place. We are seeing its removal as a public service, and we are not the only ones to say that: the chairman of the British Medical Association also

did so when he spoke on behalf of that organisation at its conference. He expressed surprise at the Prime Minister's lack of understanding of the fact that the health service is already being privatised. We are witnessing the virtual floating off of the national health service executive from the Department of Health.
If the changes contained in this Bill are laid alongside the structural changes taking place in the Department, it seems to me that the provision of health care is slowly being transferred to a quango. The NHS executive has been given responsibility for policy development in health care, a responsibility that surely ought to rest with Ministers and the Department. If they are not paid to set policy, what are they paid for? By further detaching functions from the Department and placing them under the NHS executive, the Secretary of State is in effect floating a separate arm of the health care business.
The danger, we believe, is that the same loss of parliamentary and public accountability will occur as occurred with the other Government Departments from which major functions were devolved. As a result of the creation of the Benefits Agency, hon. Members now have to take up queries and complaints not with the Secretary of State, who takes no responsibility for the service as it is provided, but with the chief executive of the agency.
One of the knock-on effects of that change was that information that had been given in parliamentary answers and published in Hansard—and thus been available to all hon. Members and the public, not just the person raising the query—was, for a long time, given only by letter to the hon. Member making the complaint or raising the query. It took a long campaign by my hon. Friend the Member for Newport, West (Mr. Flynn) before Parliament and public again gained access to this valuable information.
What the Secretary of State is doing by means of this Bill cannot be reconciled with what has been said here today. She is not devolving power. Far from it: she is just shifting the centre of power, floating service delivery off into separate businesses and thereby creating opportunities for privatisation. Shifting the centre of power in this way serves the second item on the Secretary of State's agenda. Rendering power and responsibility more diffuse shifts blame and disperses responsibility. There is nothing the Secretary of State would like better than to shift blame and responsibility elsewhere, so that they do not rest with Ministers.
Today the Secretary of State argued that organisational changes, particularly incorporating regional health authorities in her Department as offices of the NHS executive, would lead to more effective streamlining, to greater efficiency in the treatment of patients and to greater savings. She has tried to convince us that she is abolishing one tier of bureaucracy. All she is doing, however, is replacing one statutory tier of bureaucracy by another, more centralised bureaucracy. She is not even abolishing an entire tier. The Bill reveals that mental health review tribunals are to stay, on the basis of the existing regions. That is just one example of the fact that some regional functions are to continue, although it is not altogether clear how they will be managed, or what will happen to some of the other functions.
The substitution of the existing tier by another will create a bureaucracy that is to be more secretive. Staff will now be bound by the Official Secrets Act. They will be more tied to the Secretary of State's patronage and thus


more tightly controlled by the centre. In other words, under the powers granted by the Bill, far from removing bureaucracy the Secretary of State is giving herself the opportunity, through patronage, to create a more pliant and amenable bureaucracy—all of which ties in with the Maples memorandum which issued instructions to stop up the leaks and silence any criticism of the service.
While the Secretary of State increases centralised control over the allocation of resources direct to health authorities, through a new formula, there will be top slicing of money for strategic development, research and development, and education and training. It is not clear what the new formula will be; it is not clear what the degree of top slicing will be. All those decisions rest in the hands of the Secretary of State, who is taking substantial enabling powers in clause after clause.
There are references in the Bill to the orders that the Secretary of State will lay. We shall want to explore and debate the possible contents of each order very carefully.
There is a real question as to whether this recycled organisational tier—recycled, not abolished—will do what the Secretary of State promises and will slim down the burgeoning bureaucracy of the health service. There is a growing belief, which I am coming to share, that there may be an increase in bureaucracy at the lower levels of the health service, because regionally based services will now have to be run by smaller units. The British Medical Association has argued that removing the strategic planning tier will mean that hundreds of trusts and authorities will have to acquire the skills to agree on regional specialties, public health policy and a host of other issues previously dealt with by the regions.
Local authorities will have to do this with a loss of economies of scale, and will have to combine with the contracting process inherent in the internal market. We believe that that too is bound to generate more bureaucracy. That would be entirely in line with current trends under the reforms, which show that the number of senior and general managers in England has shot up since 1986, from 5,000 to more than 20,000; and that total bureaucratic costs since 1987-88 have more than doubled.
Despite these unhelpful precedents, the Secretary of State said today that there will be savings. None of them were properly costed here today, and we have some doubts about them—partly because of the context of the overall effects of the Secretary of State's reforms, which have cost the British taxpayer will over £1 billion. We also doubt them because there is a planned reduction of staff of about 1,500, and we doubt whether the savings that have been identified could come just from those staff reductions.
We also doubt the savings because of the Secretary of State's remark—or so I thought—and the idea in the Bill that possibly as much as £150 million could be saved. A press release issued after the publication of the Bill contained a revised figure of nearer £60 million. The notes on clauses and the Bill itself actually make it clear that provision has been made for an increase in the short term in the money spent by Parliament as these changes are made.
It is just over two years since hundreds of civil servants were moved at considerable cost, not to mention disruption to them and their families, to Leeds. Now 200 of them are to be made redundant, thereby creating a great deal more cost and difficulties for their families. How can it be that only two years ago these people were so needed

by the NHS that it was prepared to go to great lengths and considerable cost to move them all to Leeds, yet now, out of the blue, they are no longer needed? It is either gross incompetence or part of a different agenda.
Will the end result be that regional functions—for instance, advice on information technology, currently carried out a regional level—that will still be necessary will be contracted out? Is that the Government's secret agenda? If the functions cannot be performed owing to staff losses, will that be an opportunity for contracts in the private sector? There is certainly a widening circle of waste of public money—public money spent to take staff to Leeds, then spent to make them redundant and then, almost certainly, spent on the contracted out functions that could have been performed by those staff had they not been made redundant.
We question why the Government have proceeded with the changes in this Bill. Is it just that a further fragmentation of the health service will make it easier to privatise, as well as making it easier to bring private companies into the operations of the service? Certainly, if the Secretary of State's record is anything to go by, it is neither to slim down the bureaucracy nor to save money. She has been catastrophically bad at both.
We expect the changes in the Bill to lead to growth in bureaucracy at the expense of patients and of clinical care, but there are also wider concerns. We shall be looking closely at the allocation of responsibilities and functions as between health authorities and the regional offices. The Bill abolishes the local advisory committees, and any replacement will be dealt with by regulations. Here and elsewhere in the Bill it seems ever more clear that what the Government have in mind is dispensing with much of the expert advice that they currently receive. We do not believe that clinicians should be given excessive power to veto changes and improvements in the health service, but we do not believe either that it is advisable for management on the ground to do without the advice of experts in health policy and practice.
Who, under the terms of the Bill, will hold the contracts of junior doctors? Who will monitor the cancer screening service? Who will oversee the vocational training of GPs? Who will deal with complaints about trusts? It seems to be suggested that functions such as the oversight of communicable diseases and the handling of national confidential inquiries will mostly, or perhaps completely, be dealt with by the new, more local health authorities. However, there is deep disquiet as to whether that is the right place for them to be handled and whether such authorities will be able to or should deal with such matters.
There is alarm at what seems to be the loss of independence of the regional director of public health. The Secretary of State expressed surprise that we had drawn attention to that in our motion, although I notice that she did not go so far as to suggest that what we said was incorrect. It is an honourable part of the history and tradition of Britain that the holders of posts such as that of director of public health are whistleblowers in the interests of the general public. But in this new regional structure anybody at that level who blows a whistle will find himself on the street. There is widespread concern not only about what that will mean for the structure of the public health service below the level of regional director, but about to what extent the public will get the degree of oversight to which they have become accustomed.
As I said earlier, throughout the Bill the approach seems to be to discard in-house expertise whose impartial advice should be needed when judging the quality of information or advice which might be bought in from outside. That is only one example of ways in which long-standing and successful partnerships seem to be at risk. Despite what she said, the Secretary of State must know that the deeply held view of those in medical education, whether at undergraduate or postgraduate level, is that the combination of academic and clinical roles is an essential prerequisite of the training that has been provided hitherto. That view is held by the universities and by the health service.
Despite what the Secretary of State said about the consultations that have been held, she must be aware that that structure is perceived by people, including the Committee of Vice-Chancellors and Principals, to be put at risk by the changes. She must also be aware that there is real anxiety about the nature and scale of future medical education not only in the medical profession but in ancillary professions. Despite the impression given by the Secretary of State, that anxiety has not been dispelled.
The most professionally anarchic proposal of all is the Government's aim to devolve pay to local level. If anything will lead to increased costs and bureaucracy, it is that ill-thought-out policy. The time of managers will be used up in lengthy local negotiations on pay and conditions. Doctors, nurses and other staff will find themselves neglecting patients because they will be expected to attend to their own pay negotiations. The National Association of Health Authorities and Trusts has already said that the administration of local pay schemes alone will cost an extra £40 million.
The Secretary of State talked about people wanting to reduce matters to the lowest common denominator. No Opposition Member wants to do that, but that is what local pay is all about and that is what the Government are trying to achieve. They are trying to create a scenario in which pay and conditions can be cut, although where scarce skills are needed competition between trusts to attract and retain professional staff seems likely to lead to options for those specialties in which more than 480 different bargaining units will have to engage in competitive bids.
We do not intend to let the Government or the public forget what is already occurring in the structure for which the Government make such claims. An example of such an occurrence is to be found, I believe, at the Royal Marsden hospital, where a circulated memorandum suggested that someone should be hired not merely because he was the best in his clinical field but because removing him from another hospital would destabilise a competitor. Competition rather than co-operation will be further enhanced by local pay, which will also distort clinical priorities.
Skilled clinicians will no longer move from hospital to hospital for professional development reasons alone. Hospitals with research teams and research facilities will no longer seek to attract people primarily because they are innovators at the frontiers of scientific development: they will also depend on the pay that the chief executive can offer.
Some trusts will not be able to enter that competition. The director of personnel at the Havering Trust has already announced that he has to save £3 million in the next three years. How will that trust be able to attract or retain scarce skills during that period with the anarchy of purely local pay bargaining? How will patient care be delivered in that locality in those circumstances?
The Secretary of State expressed surprise that we wished to move a reasoned amendment rather than simply supporting the Bill. As we have made plain, we did so because we oppose the abolition of the NHS regions in their present form, although we welcome some of the Bill's other proposals.

Mr. Tim Smith: Ah!

Mrs. Beckett: I do not know why the hon. Gentleman says that; I made our position clear at the outset, but perhaps he was not here at that time.
Above all, oppose the way in which the functions of the regions will be dispersed and broken up. We oppose further fragmentation of the health service and we believe that behind the Bill lies the hidden agenda of breaking up and floating off different NHS functions and making them ripe for picking by commercial interests. As Mr. Maples advised, the intention is to silence the staff while that is happening.
At best, the Bill fails to address the real problems of health care in Britain. At worst, it exacerbates the problems that Government reorganisation has created. The Secretary of State repeated phrases that she has used in every speech that I have so far heard and read. There is the suggestion that under what she calls the old NHS there was a command and control structure, which she attacked. A command and control structure of a kind that no previous Secretary of State has enjoyed is precisely what the Bill introduces to the health service. For the sake of our national health service, that process, like the Government, must soon be brought to a halt.

Mr. Colin Shepherd: I am pleased to be called to speak so early in the debate. Those of us who take an interest across the spectrum of activities in our constituencies have to address the issue of health service delivery against the background and the experience of our constituencies. The changes that have been made in Herefordshire over the past few years, and especially the change in the make-up of the county's health authority and the bringing in of executives with particular expertise, have been beneficial. Therefore, the Bill is a logical next step and I have no quarrel with it in principle. I shall certainly support it in the Lobby.
I support the Bill's concept of endorsing local decision making in the NHS. That is very much at the core of the admittedly constituency interest that I wish to put before the Secretary of State and the Minister of State. We are greatly worried about how health services in Herefordshire could be affected if there is unsympathetic implementation of the Bill's proposed changes. I emphasise that the reforms must make sense to people if they are to be supported and understood.
My worries are about the imminent decisions that will be made by West Midlands regional health authority in its dying days. That authority has been charged with the


responsibility of predicating the shape and number of health authorities in what is currently the west midlands region.
My Herefordshire health authority—I take the proprietorial "my" on behalf of my constituents—is already the smallest in the country, with the exception of that for the Isle of Wight. It is working fairly well and is consistently meeting all the national targets. It is financially sound, it is at the top of the efficiency index in the west midlands, its management costs are well below the average for equivalent-sized authorities, and it has taken more steps to identify further reductions in those costs. This year, it knocked £200,000 from its management costs.
What is worrying is that, on this coming Thursday, 15 December, the regional health authority will decide its policy for the counties of Hereford and Worcester. It is anticipated that the recommendation will be that there should be just one new health authority covering the two counties.
The authority has arrived at its recommendation—although I think that "decision" would be nearer the mark—without very much consultation, and certainly not without its own walls. Its own statement says that consultation is
limited at this stage primarily to Health Authorities".
I inquired where the consultation had taken place and discovered that there had been little in Herefordshire. Indeed, I am not entirely sure who has been consulted.
The two county Members of Parliament—myself and my hon. Friend the Member for Leominster (Mr. Temple-Morris)—had a meeting with the health authority chairman and the director of performance management, at our request. It was certainly not a consultation because we were making representations. I understand that the chairmen of the health authorities were not even consulted. The general managers of the four health authorities concerned were summoned to the regional chief executive and told what was to be the case.
What the matter boils down to is that, without much consultation, the regional management executive has determined what is to be the case and, presumably, will go out to consultation. What will be the value of that consultation if, as I perceive, decisions have already been made and written on tablets of stone?
I am not alone in feeling great hostility towards the proposed move. Everything in me shrieks against it. I do not believe that it is necessarily in the best interests of my constituents in Herefordshire. I am not alone in that view—the general practitioners and their council in Herefordshire are unanimous in their opposition to that particular shape for the health service. The clinicians, the consultants, the joint operation of clinicians and general practitioners, the Hereford medical forum and everybody else involved in the medical sector are unanimous in their opposition.
The foundation for that opposition comes from 20 years of local government experience. It shows that where Herefordshire has been linked to the larger population base of Worcestershire there has been an inexorable suction effect away from Herefordshire and into the heavier weight of Worcestershire. A classic example of that is the eight years of the Hereford and Worcester area health authority between 1974 and 1983. It was like trying

to get hold of a cotton wool cloud. We could not get hold of the authority; it simply was not there in tangible form—it was too busy sitting in committees.
I am told that circumstances have changed and we have moved on, that I must not lock myself into 1974-type thinking and that I must adjust myself to today. However, our experience over the past 20 years is that, whenever small Herefordshire has been linked to large Worcestershire, because the demographic weight of population is to the east of the county, we have not benefited.
We actually made progress from 1983 onwards when we were given our own health authority. It was identifiable and small. At the time, we were told that it would be too small, but we said, "Let it run." It has been very successful and it has made progress. From my point of view as a Member of Parliament dealing with constituents and the health authority, I have found the lines of communication both short and effective. There have been good results in sorting out problems and unscrambling messes when they have occurred.
In Wolverhampton on 26 October, my right hon. Friend the Secretary of State told the chairmen of health authorities and trusts in the west midlands region that the new health authorities would be the stewards of the local community. The question being asked in my part of the world is: how local is local? The west midlands—. Birmingham—is light years away. I must inform my right hon. and hon. Friends that Worcester is also light years away. That might seem very parochial, but our area is sparse and large distances are involved. There is a range of hills in between. We are not the same. Over the years, we have tried to work in many different forums on a Hereford and Worcester basis, but none has been effective in its operation.
Where is the sensitivity to local needs? We need reassurance on that point from my hon. Friend the Minister. Herefordshire has a high elderly population, a low ethnic population and an old town. Redditch, on the other side of the joint county arrangement, has a high young population and a new town. Worcester has an old town and a high ethnic population. If the weight of population is to the east, how will sensitivity to the west be recognised?
In terms of finance, we are worried that the loss of sensitivity to the Herefordshire population profile will leave us at a disadvantage. We are very worried about the potential lack of sensitivity to the more rural parts of Herefordshire and beyond. My hon. Friend the Minister with responsibility for health matters in Wales knows full well how far into Wales runs the catchment area for Hereford, which is looked to as the centre for the provision of acute hospital care.
I am aware that my right hon. Friend said that we must not look for sectional interests on the area health authority, but unless there are people who come from the Herefordshire side of the hills there cannot be a recognition of what Herefordshire needs. I am not making sectional interest pleading; I am asking how Herefordshire's needs will be understood. It is not all number crunching. It might look very tidy from the inside looking out, but from the outside looking in it is not quite so tidy and comfortable.
All our experience suggests a shift of services to the centre of gravity of the combined area. Our worry is that that would be detrimental to the range of hospital facilities


that will be available in Hereford—not immediately, as these things take time—and that over the years there will be a migration of services as people rationalise and strategic decisions are taken about what is done where and how. In 10 years' time we could find ourselves not with the present acute hospital unit providing a broad range of clinical services, but with a hospital providing an accident and emergency service and the ancillaries that go with that. That worry must be laid to rest.
I am glad to see my hon. Friend the Under-Secretary in his place. When I explained my fears to him, I am afraid that his reply merely underlined them. My fears reflect those expressed to me by my constituents. I very much hope that my hon. Friend will be able to reassure us.
The regional health authority will put a paper before the meeting on Thursday. The reasons given in that paper for its decision seem to me to be self-justificatory bull.

Mr. Alex Carlile: Not Herefordshire bull.

Mr. Shepherd: Definitely not Herefordshire bull—Birmingham bull.
It appears to me that the authority's attitude is that a decision has been taken, so it must make everything fit it. I am told that the new authority will operate best against
a sensibly sized strategic canvas"—
marvellous; furthermore:
Local sensitivity will be assured by Primary Care-led purchasing, and the extensive development of GP Fundholding
covering 87 per cent. of the population. I wonder what the sensibly sized strategic canvas will be. I was told that Hereford is too small to support both a strategically focused health authority and an extended range of GP-focused purchasing. When I met the regional health authority chairman and his colleague, I was told about the "theology of numbers" for a successful operation, which is somewhere between 300,000 and 500,000 residents.
When the Herefordshire health authority started, we were told that the population was too small at 140,000. I pleaded with the then Minister and he accepted my arguments, and we have a successful health authority as a consequence. It covers 160,000 people, and the mid-Wales dimension takes the figure to 250,000—not far short of the bottom limit of the theology of numbers. However, having pursued that matter with my hon. Friend the Minister, I understand that there is no bottom limit but that it is a matter of what makes sense. The regional health authority seems to be making rules to suit itself. What is the foundation for that theology of numbers?
It is suggested that a single health authority would attract high-quality staff and administrative savings of £1.5 million, which would be available, if it materialised, for reinvestment in local health services. I understand that the Price Waterhouse report is distinctly suspect and that if there were a single commissioning authority or health authority for Worcestershire and one for Herefordshire, the savings would be not £1.5 million but £500,000.
I am worried about the numbers that will be put before the regional health authority on Thursday. The regional chief executive's report dated 21 July stated that the situation in Hereford and Worcester is much more complex and that local ownership and accountability within any arrangement is more important than financial considerations. That is intriguing, because it implies two lines of thought.
We have marvellous clinicians in Hereford. They like working there and do not wish to leave, and there is no reason for them to do so. The quality of life in Herefordshire is darn good, and they do a good job.
The third argument is a wonderful piece of jargon. It is that NHS providers in particular will find it easier to shape their future against a clearer purchasing and commissioning strategy. That is true whether the authority is large or small. The argument is also made that the functional clinical links developing between providers across the county make a clear purchasing view all the more important and urgent. Those links will be made whether there are one or two authorities because they make sense. That is not a reason but a reflection of something that will happen as a matter of logic.
It is said that the business cases for the Hereford and Worcester hospitals are nearing completion, and that the Hereford scheme in particular should have its outline case approved by the regional office by the end of December.
I have been pursuing the establishment of a hospital since 1974. Hereford has three clapped-out building sites, one of which has finally been identified as a site for redevelopment. It is expensive, maintenance is bad, and it is difficult to see how services could logically be provided. In addition, the site is dangerous. A cardiac arrest on the operating theatre in the general hospital would necessitate an ambulance run to the county hospital's intensive care unit, which is unacceptable. I urge my hon. Friend the Minister to press for the completion of that hospital at the earliest possible moment.
Although the business case was presented in Birmingham today, I received from Mr. Brian Baker, chairman of the regional health authority, a note saying, "Hold on a second. We cannot go now on the shape of the Hereford hospital—not until such time as we know what is to happen in Worcester." That emphasises my worst fears. The two are interdependent, but decisions are being taken before we are ready.
I support the Bill's principles because they are right, but I urge my hon. Friends on the Front Bench to make a sensible arrangement for my part of the world, because it is different by virtue of its geography and demography. The reforms must make sense for people if they are to secure support.
What message are the Government sending my constituents? At 9.30 am on Thursday morning, the Local Government Commission will make an announcement, which I would bet heavy money will say that there should be a unitary authority for Herefordshire. It will recognise that the connection with Worcestershire over the past 20 years has not been to Hereford's advantage, and that its people think that they can do better. At 10.30 am, the regional health authority will say, "We are taking away Hereford's independence and will tag it on to Worcester to make a big merged health authority."
Although Hereford's health authority is small, it is good. It could be nicely merged with a family health services authority to form a new authority that is responsive to the needs of the people and understands them. The logical way for my hon. Friend the Minister to progress is to say, "I hear you, Herefordshire, and your worries. You will have a health authority in your own right." He can enter the caveat that, if that does not work, he will exercise the Bill's inbuilt powers to put Hereford together with another health authority, possibly


Worcester. He can do that if, in the light of experience, shortcomings are identified, and the individual authority is perceived not to make sense. I urge my hon. Friends on the Front Bench, as I support them tonight, to listen to us in Herefordshire.

Mr. John Heppell: The Secretary of State said that the Bill exists to take account of Government reforms, but all those made so far have been utter failures. I see no reason why the Bill should not also be a complete failure.
The Secretary of State asked for facts and statistics. Government health reforms so far have cost £1.2 billion, which has meant that the cost of NHS bureaucracy has risen from £1.44 billion to £3.02 billion—an increase of 110 per cent. or £1.5 billion, which could have been spent on patients rather than on administration.
The right hon. Lady spoke about streamlining management. In 1986-87, the national health service had 500 managers. In 1989, it had 4,600 and by 1993, it had 20,010. That is an increase of 1,800 per cent.—not quite as large as the increase in prescription charges, but almost. In 1987, management costs were £25.7 million. Today, they are £49.8 million. That is what the Government's reforms have meant; those are the statistics for which my right hon. Friend the Member for Derby, South (Mrs. Beckett) was asked.
The Government say that they want to introduce further reforms that will save more money and make the NHS more efficient and effective. Does any Conservative Member seriously believe that we seriously believe what the Government say? They say that they plan to remove a tier of the health service, but when we examine the small print we find that they do not really mean that. They plan to remove regional health authorities—the section of the service that secures accountability at regional level.
It is no use for the Secretary of State, and other Conservative Members, to talk about the way in which people are appointed to trusts or regional health authorities. Every hon. Member—and, I suspect, everyone in the country—now knows that one overriding criterion ensures appointment to trusts, district health authorities and regional health authorities: allegiance to the Conservative party. More than half the 240 health authority chairs come from businesses, consultancies or financial institutions. They are directors and employers in firms that donate money to the Conservative party. Only 15 of those 240 have any medical background, but more than 120 have financial backgrounds.
If the appointees are not directors or other members of firms that give money to the Conservative party, they are members of the party. I know from experience—as, I am sure, do other hon. Members—that prominent members of Conservative associations are repeatedly appointed to trusts and health authorities. The same applies to Conservative candidates, both national and local. They are usually failed candidates, but what does that matter now? If a candidate cannot persuade the country to let him put his ideas across by means of the ballot box—if he cannot secure the changes that he wants democratically—it does not matter. As long as he has an allegiance to the Tory party, the Government will appoint him to a quango, such as a trust or health authority.
Not only those people themselves but their wives, brothers and brothers-in-law may be appointed. They have this in common: they are all yes-men, or yes-women, in relation to what the Tories want to do. In fact, regional health authorities do not pose much of a threat to the Government; they produce little opposition to the Government's proposed changes. Every now and again, however—not very often—we see a bit of independence and initiative, and hear a few murmurs of discontent and disagreement. For that reason, RHAs will have to go. The Bill is not about removing a tier of the NHS; it is about removing accountability.
Are the Secretary of State, the Minister and other Conservative Members trying to tell me that nothing needs to be done at regional level any more? I have taken time to read research paper 94/124, produced by the Library. A section beginning on page 11 asks:
Who will do what in the new NHS?
I have highlighted the instances in which it is still necessary for the region to act, and almost every part of the section has been highlighted as a result.
The regional officers will still set the local research agenda within a national research and development strategy developed by headquarters, and will manage research and development projects. When the revenue allocations are made directly to health authorities, surely the NHS executive will use its regional tier to establish what those allocations should be. When the responsibility for public health functions goes to local health authorities, regional offices will ensure
that effective arrangements have been put in place".
When the professional advisory machinery is at local or multi-district level, the current sub-committees—the specialty sub-committees—at regional level will retain their responsibilities:
regional offices will be responsible for performance management of health authorities and for monitoring Trusts".
After that, they will have new responsibilities for GP fundholding. The regional tier will still have to do a great deal of work.
I find it hard to accept that the changes at regional level will save £150 million. How can 1,500 jobs disappear when all that work will still have to be done—unless, as my right hon. Friend the Member for Derby, South suggested, the plan is to contract the work out to private companies which are probably making large donations to the Conservative party? In any event, why are the RHAs being targeted in connection with bureaucracy? Bureaucracy has not increased in the RHAs.
Between 1992 and 1993, regional staff numbers fell from 7,845 to 3,905—a massive drop, as everyone would surely agree. Moreover, in the following year the numbers fell to 2,613. Meanwhile, bureaucracy has increased in the trusts, in the FHSAs and at district level, but predominantly in the trusts. If bureaucracy is to be tackled, they should be tackled. It is nonsense to abolish the tier in which bureaucracy has been slimmed down—the tier that has been made lean and mean—and preserve organisations in which bureaucracy continues to flourish.
A limit of 135 staff has been set for each region. Can anyone tell me how that number was arrived at? Is there no difference in the size of the regions? Is not the regional authority represented by the hon. Member for Hereford (Mr. Shepherd) smaller than some others? If the size indeed varies, will not differing staff numbers be required?
The truth is that the figure was plucked out of the air—and, even if it is met in the short term, I am certain that it will not stay the same in the medium and long term. As I have said, the work that needs to be done at regional level will continue. I guarantee that no future assessment of the number of staff required will produce a figure of 135, if it is done correctly.
Although I agree in principle with the amalgamation of the district health authorities and the family health service authorities, I have very strong reservations about whether the Government will carry it out efficiently and effectively. I have evidence that in some areas it is not being carried out efficiently and effectively.

Mr. Malone: It would be a little presumptuous if it were being carried out wholesale while the Bill has not yet received a Second Reading. There are a number of co-operative arrangements in place, which is very different from sorting out the amalgamation once the House has sanctioned the Bill. Surely the hon. Gentleman understands that.

Mr. Heppell: I understand it, but it seems that the Secretary of State does not. My hon. Friend the Member for Sherwood (Mr. Tipping) wrote to her pointing out that the Nottinghamshire FHSA and the Nottinghamshire health authority had combined—informally—to form a health commission and had proceeded to pick a new chief executive who is already in post and being paid. The chief executive of the Nottinghamshire FHSA has been sent home on what is described as "gardening leave". That person is on a salary of perhaps £50,000 or £60,000 but has been sent home before Parliament has even debated the necessary legislation because someone else has been given the job of taking over the new amalgamated health authority, which the Minister says should not yet be in place.
Perhaps the Minister will tell me that he proposes to take action against members of the health authority or the FHSA or against the chief executives of both bodies for proceeding without parliamentary approval. The Minister shakes his head. He clearly accepts that inefficiency has been engendered by the attempted amalgamation of two bodies without there first being in place a proper structure and without there first being a proper debate with the medical profession and members of other services involved. I am sure that the Minister will therefore accept that I am bound to have some reservations about the Government carrying out the reforms and achieving the savings they seek.
The Bill will be a failure because of what is not in the Bill as much as for what is in it. It does not tackle the real problems in the NHS. It does not deal with the fact that there are now 1 million people on the waiting list and that there is a secondary list of 1 million people waiting for out-patient appointments. The Bill does not tackle the fact that, since 1979, 147,790 beds have disappeared from the health service and that some people are now finding it impossible to get a bed.
The Bill does not deal with the fact that, in 1993 alone, 10,637 beds disappeared from the health service or that since 1979, 538 hospitals—or one in five—have closed. It does not deal with the patients charter. We learned only this week that the charter's targets are not being met. Nor

does the Bill tackle the problems of increased prescription or dental charges or the cost of eye tests. It does not tackle the fact that we now have fewer nurses than ever—in 1989, there were 397,650 nurses but by 1992 the number had dropped to 361,460.
The Bill does not solve the problem of perks going to the most well paid people in the NHS or the excessive pay rises that some people award themselves. Last year, the average pay claim by chief executives was 8.5 per cent. although some awarded themselves 33 per cent. even while the Government were telling public sector workers that their pay should not rise by more than 1.5 per cent. How can the Government in all honesty say that to ordinary NHS workers while some chief executives award themselves 33 per cent.?
The Bill does not deal with complaints which have increased by 57 per cent. to 58,000 a year and nor does it tackle staff morale. My right hon. Friend the Member for Derby, South mentioned the fact that the Government were trying to introduce locally negotiated pay. Only today I had a visit from a member of the British Medical Association, Dr. Gill, who is on the local negotiating committee. I am sure that he will not mind my mentioning that he told me that locally negotiated pay would be disastrous. It would mean that, in addition to their management and administration duties, hundreds if not thousands of doctors would have to attend one or two meetings a week to negotiate pay, whereas, at the moment, it is negotiated nationally and effectively and no one has complained.
The Bill gives the impression that it will cut bureaucracy but it will not; it gives the impression that this is the end of the NHS reforms but it is not; and it gives the impression that it will help the NHS but in reality it is a collection of bogus measures which are, if anything, simply a public relations exercise for the Government. The Bill's provisions are a smokescreen for the NHS reforms that have already taken place, and for the Government's betrayal of the service.

Mr. John Whittingdale: I hope that the hon. Member for Nottingham, East (Mr. Heppell) will forgive me if I do not agree with him entirely. I find extraordinary the Opposition's constant desire to denigrate dedicated individuals who are trying to improve health care in their communities and especially strange is the idea that anyone who has had any association with Conservative politics—or who happens to be related to anyone in Conservative politics—should not be allowed to serve on a regional or district health board.
I shall not take up too much of the House's time because, despite the speeches that have been made so far, I do not think that the Bill is especially controversial. It is quite narrowly defined and technical, although that might not be immediately apparent—I note that schedule 1 will require 45 Acts to be amended, including the Polish Resettlement Act 1947, the Dartford-Thurrock Crossing Act 1988 and the House of Commons Disqualification Act 1975. Despite the wide-ranging nature of the Bill, I do not think that it is controversial, and it has received wide support, especially outside the House.
I agree entirely with my right hon. Friend the Secretary of State that the Bill is the logical consequence of our national health service reforms which were undoubtedly the most radical change to the structure of the NHS since it was created. Much of the attention since then has been given to the establishment of NHS trusts, and I was pleased to hear my right hon. Friend announce today that the coverage of the trusts is to be extended further to take in, I believe, 98 per cent. of patients. Attention has also been given to GP fundholders whose numbers have been growing steadily, but the biggest NHS reform was the creation of the internal market and the separation of purchasers and providers.
The Bill reforms the structure of the purchasing side of the national health service, which I have always believed is at the core of the NHS. I do not take the ideological, rigid view that the NHS should use only publicly owned providers. I am happy to see it use privately or publicly owned providers, as long as they deliver the best possible treatment to patients. The core of the NHS is its purchasing function, and the Bill concentrates upon that.
Three and a half years on, we can now begin to make a judgment about the results of the NHS reforms. Despite what the right hon. Member for Derby, South (Mrs. Beckett) said in her speech, I have absolutely no doubt that the reforms have worked. NHS trusts have been an unqualified success. General practitioner fundholders are providing better care to patients and, as a result, the number of patients being treated has increased and the quality of care has improved.
A couple of weeks ago, The Guardian stated that the NHS reforms had achieved "considerable success" in helping to restore confidence in the NHS. I take it that that was not written by the KGB.
Inevitably, when reforms as great as the NHS reforms are introduced there will be some problems. I accept that one such problem is the number of layers of management created and the amount of money spent on administration. I do not accept the more simplistic charge that the reforms have simply created layers of management. An organisation the size of the NHS must have strong management. It spends the equivalent of a small country's gross national product, and it must have properly qualified, good managers to ensure that we receive maximum value for money.
One of the reforms' main intentions was to devolve responsibility downwards—to give real decision-making power to those who are involved in running hospitals and to the GPs who have chosen to become fundholders. Devolution of responsibility has led NHS trusts, quite correctly, to recruit more management staff. The problem is that that increase has not been matched by a corresponding reduction in the number of administrative staff employed elsewhere within the NHS. The recruitment of more managers in NHS trusts should mean that many managers are no longer needed at the upper level of the health service. The Bill is designed to address that problem.
The disappearance of regional health authorities will require one or two of their tasks to be performed elsewhere. A traditional responsibility of the regions was the allocation of funds within a region using a weighted capitation formula.
The House has heard me talk previously about the consequences of that funding allocation in the North Thames region. I do not wish to go over familiar ground in detail, but I repeat that there has been a problem. Although there is a national formula to distribute funds between regions, when a region such as mine adopts a different formula for the allocation of resources within a region it leads to unfairness, particularly in my district of North Essex.
Because the national formula does not take full account of the social deprivation factors which the region uses to distribute funds within North Thames, North Essex has been doubly penalised. I have raised the problem with the Minister previously, so I do not wish to spend too much time on it tonight. However, as a result of the changes introduced by the Bill, I hope that the Department will implement a single national formula to allocate funds between districts. That will remove the present unfairness and ensure that all districts are treated equally.
The regional monitoring role must continue to be performed. It has been suggested that part of the role can be performed by the new health authorities— in particular, that they will be responsible for monitoring GP fundholders. As the British Medical Association has pointed out, the new authorities will also be competing purchasers. It concerns me that they will be not only competing with GP fundholders, but given responsibility for them. Will the Minister explain how the system is intended to operate?
At district level, I believe it must make sense for a single body to be responsible for ensuring that patients receive the proper degree of health care. The division between primary and secondary care has always been pretty artificial; it is now breaking down even further.
More and more treatments can be performed in a GP's surgery and no longer require a visit to hospital. When hospital treatment is needed, it is often performed on a day-case basis and no longer requires an overnight stay. In some cases, GPs will come into hospitals and use their facilities to treat patients and, as a result, consultants and registrars do not need to be involved.
These changes—many the result of technological change within the health service—will inevitably alter the profile of the health service. In future many people will not need to go anywhere near hospitals; their local GPs' surgeries will become mini-hospitals. Judging the performance of the health service, as the hon. Member for Nottingham, East did, on the basis of the number of beds available or the number of operations performed will become increasingly irrelevant.
I congratulate the Secretary of State on the speech that she made earlier this year—I think it was to the National Association of Health Authorities and Trusts conference—in which she drew attention to the changes that will take place in the health service. She highlighted the report by the United Kingdom chief nursing officers, who predicted that in future 60 per cent. of operations are likely to be performed on a day-case basis, 40 per cent. of specialist consultations will take place outside hospital and, as a result, 40 per cent. fewer beds will be needed.
The figures caused great uproar when they were first published, but it is an inevitable consequence of the technological change which is taking place in health


care. It is important that we should recognise it and debate now the consequences for the shape of the health service in the future.
Separation of the body responsible for the purchase of secondary care—in other words, the district health authority—from the body responsible for primary care is becoming increasingly daft. Many areas have recognised that already: commissioning agencies have been formed, with close co-operation between the two bodies.
In North Essex relations between the family health services authorities and the two DHAs are very good. Following my right hon. Friend's statement earlier in the year, the FHSA and the two DHAs talked about the structure of future health provision in the county. Clearly, the main question was whether future health authorities should be divided into two or three different bodies, or whether a single body should have jurisdiction over the whole county.
As well as engaging in wide consultation, the FHSA and the DHAs commissioned the King's Fund to investigate and make recommendations on that point. I was sorry to hear about the experience of my hon. Friend the Member for Hereford (Mr. Shepherd), who did not feel that sufficient consultation had taken place in his constituency.
Very wide consultation has taken place in Essex and, as a result, there is almost universal agreement that the most sensible structure is to divide the county along existing district health authority boundaries and to have two health authorities in future. I congratulate the three chairmen—Major-General Robert Wall of the FHSA, Alec Sexton of the North Essex health authority, and David Micklem of the South Essex health authority—on the way in which they conducted the investigations into future health provision in Essex. I think that their recommendations will enjoy widespread support and prove a great success.
I will touch upon one or two concerns that have been raised already in the debate. The first concerns accountability within the health service. I agree entirely that it is essential that the public have confidence and feel that they are fully involved in decisions affecting patient health care. The Bill is not entirely clear about the membership of the new health authorities—although I welcome the Secretary of State's clarification in her speech. I hope that members of the future health authorities' boards will be widely drawn from within the local community.
Clearly, the membership should include medical professionals. I especially welcome the announcement that the director of public health will be a mandatory executive on the health board, but I believe that a wide range of individuals who have specific skills to bring to bear should also be involved. I especially hope that there will be full involvement of the primary care sector. It is important that the new authorities should not be based mainly on the existing DHAs and that they should properly reflect the responsibilities of both the DHAs and the FHSAs.
As I have said, it is essential to try to increase public involvement in the provision of health care. North Essex health authority has been extremely good at trying to involve the public. I cite the public consultation

exercises that the authority has carried out on the provision of cancer services in the county which has recently led to the recommendation that there should be a new cancer centre in my town of Colchester. I also cite the consultation exercise on the provision of orthopaedic services. The original proposals for orthopaedic services to be centred on a single site in Broomfield were dropped as a result of the consultation exercise and new proposals have now been introduced for two centres, one in Chelmsford and one in Colchester.
I also cite the exercise in determining public priorities for medical treatment within the county. Many consultative documents were issued by the health authority, but, unfortunately, there was a lack of response to the documentation. I know that the director of public health was rather disappointed by the number of responses he received. One parish council in my constituency complained about the number of consultative documents it received and said that it was unreasonable for it to spend so much time answering them. That is a problem. I hope that consultation exercises will be phrased in simple language so that they will generate a proper response from those who wish to participate.
One of the interesting results of the recent visit by members of the Select Committee on Health to Oregon, where a wide-ranging consultation exercise has been carried out, was the discovery that the people who came along to the public meetings were not members of the public at all. They were health professionals. There must be the danger that a limited response to a public consultation exercise may not properly reflect public opinion in the locality.
I commend the fairly novel approach of Alec Sexton, who is the chairman of North Essex, one of the health authorities. He has started to hold public surgeries and he invites members of the public to raise with him any concerns they have about the provision of health care. That is an extremely welcome innovation and I hope that his example can be followed widely by the new health authorities.
Another problem has arisen in my area which the new authorities will need to consider—the growing number of patients who are being removed from GP lists. In Essex, there has been a slow but steady rise in the number of removals, from 977 in 1991 to 1,154 in 1993. I entirely accept that the figure still represents only seven out of every 10,000 patients, but I believe that it is a cause for concern.
It has been claimed that the increase is the result of fundholding practices seeking to remove patients who will be costly to their budgets. There is no evidence to support that claim. Indeed, the evidence in Essex proves precisely the reverse. In my mid-Essex area, there are fewer removals by fundholders than by non-fundholding practices. I accept that a doctor must have the right not to have on his list a patient with whom his relationship has broken down, but it is not acceptable for a doctor arbitrarily to remove a patient from his list, especially if no proper explanation is given to that patient. In rural areas such as mine, real problems can be created if the nearest alternative practice is many miles away. I should like there to be a requirement for doctors to justify the removal of a patient from their list and,


perhaps, for an arbitration scheme to be established to try to prevent the problem where possible. I hope that my hon. Friend the Minister will consider that point.
I now turn to the responsibility of the new health authorities for long-term care. As the House is aware, lead responsibility for the provision of community care rests with the local authorities. However, the availability of social care is, obviously, a paramount consideration in determining whether a patient is to be discharged from hospital. If adequate social care does not exist, patients will have to be kept in hospital, thereby putting additional strain on the health authority's budget and occupying badly needed beds. Essex county council, in common with a number of other Labour and Liberal Democrat-controlled authorities, has announced that its community care budget is close to exhaustion. That will cause real difficulties for the health authority.
It has been claimed that, in Essex, community care has been inadequately funded. That simply is not true. The amount available to spend on social services this year stands at £175 million, which is an increase of 22 per cent. on last year's figure and 7 per cent. more than the national average. The change in the distribution of the special transitional grant, which some local authority social services departments claim has penalised them, has benefited Essex by a further £21 million. The principal reasons why Essex county council social services department is now in that position are simply mismanagement and the council's failure properly to plan its budget in advance.

Mr. Hinchliffe: I have listened with interest to the hon. Gentleman's comments about community care. The subject does not have a great deal to do with the. Bill, but it is important to make one point. Does the hon. Gentleman recall, that in the first year of the care changes, the Association of County Councils made the point that community care was underfunded? At that time, the association was controlled by the Conservative party.

Mr. Whittingdale: I simply do not accept that community care has been underfunded. The hon. Gentleman will find that this area of local government responsibility has received better funding than almost any other and that the funding has been steadily increased since the changes were introduced. There is no justification for local authorities to claim that their budgets have been exhausted. Such claims have aroused fears among some of the most vulnerable people in society, which is a disgrace.
Essex county council's reserves stand at about £25 million. The council should simply transfer some of that money to make up any shortfall and it should take immediate action to ensure that such a situation cannot be repeated. I can see that you are looking at me, Madam Deputy Speaker; I am conscious that I have strayed a little from the Bill. I thank you for your indulgence.
I have no doubt that the Bill will result in a more efficient and streamlined structure for the NHS. It will consequently result in real benefits for patients.

Several hon. Members: rose—

Madam Deputy Speaker (Dame Janet Fookes): Order. Before I call the next hon. Member to speak, I

must point out that, so far, no Back-Bench speaker has managed to make a speech in less than 20 minutes. If that trend continues, there will be some disappointed Members who will not have made a speech at all. I hope that I make the point clear.

Mr. Alex Carlile: I cannot resist starting with a reference to the strong plea that the hon. Member for Hereford (Mr. Shepherd) made on behalf of the Herefordshire health authority. I have a lawyerly connection with Hereford and, as a Member of Parliament for mid-Wales, I am well aware of the number of patients, especially from the south of the county of Powys, who go to Hereford for the very good hospital treatment in that ancient city. The hon. Gentleman's argument was sound and not merely on a local basis relating to his constituency, although that stands too.
I am glad to see the Under-Secretary of State for Wales, the hon. Member for Clwyd, North-West (Mr. Richards), in his place. In his presence, I ask the Government to ensure that, during the reorganisation, close attention is paid to ensuring that patients who seek treatment, or are sent for it, across the Welsh border will continue to be able to receive it efficiently.
The consideration that the hon. Member for Hereford mentioned applies equally to constituents in Brecon and Radnor; and to my constituents, who go to Shrewsbury for much of their treatment. Indeed, it applies in particular to the Minister's constituents in Clwyd, many of whom gravitate towards Chester for treatment. Cross-border availability is an important issue. There has certainly been a feeling in my constituency that the Shropshire health authority has tended to look east, to the neglect of the western part of its catchment area. The reorganisation should not allow that trend to continue.
I have a feeling that, while drafting the Bill, the parliamentary draftsman was reading the Maples memorandum. We have four pages of Bill and 50 pages of schedules. I suspect that the instructions might have been to make it so dull that it would introduce legislative anaesthesia and possibly euthanasia of the Standing Committee—Oregon was mentioned a few minutes ago—so that the politics of the Bill, or indeed the whole Bill, would be forgotten.
Beneath that textual exactitude, which the draftsman so skilfully incorporated—especially in schedule 1—lies a breathtaking transfer of power. Breathtaking powers are to be placed in the hands of the Secretary of State and of unelected and extremely large public bodies. Of course no one objects to reorganisation if it improves the quality of service, unless one takes a dogmatic view as to whether all health care should be provided by the public or the private sector, which I do not. I hope that we will gain an assurance from the Minister in his reply, especially in answer to the hon. Member for Hereford, that it is improving the quality of service that drives this reform and not some organisational ethos, which is what crept into that remarkable jargon that the hon. Member for Hereford read to us earlier.
Reorganisation is unacceptable if the quality of service is not improved. We must bear in mind the fact that those extraordinarily large and totally unelected public bodies will take decisions that will affect the fundament of people's lives. They are the organisations that will decide—as some have decided not to—whether to pay for


extra coronary operations, above the number of operative treatments for which they have contracted. Like the existing Powys health authority, which is responsible for my constituents, they are the authorities that will produce proposals that may mean emergency ambulances only in a large and sparse rural area. No one could imagine a decision—based on financial stringencies, of course—that could be less calculated to serve the large, local, elderly population.
Those are the authorities that make arbitrary judgments—again like Powys—such as the decision that, as a matter of policy which I believe to be unlawful and capable of judicial review, childless couples will in no circumstances be able to gain fertility treatment on the national health service. Such decisions should never be taken, but the lack of any sort of democratic accountability, whether in the old or the new authorities, renders them more likely.
Beyond those general considerations, I must deal briefly with six specific issues. The first has already been mentioned—predictably so—and concerns how members of the authorities will be appointed. Will there be yet more epidemic and centralised patronage? I want to be fair. The Labour Government's record on epidemic patronage before 1979 was every bit as bad as that of Conservative Governments since. There is no reason for it to be so. For example, why will the Department of Health and the Welsh Office not advertise for possible non-executive members of the authorities? Why trawl among the great and the good and those with whom they happen to go to cocktail parties, rather than advertising every one of the posts in the regional press, so that the trawl can be made from the widest range of possibilities?

The Parliamentary Under-Secretary of State for Wales (Mr. Rod Richards): May I enlighten the hon. and learned Gentleman by telling him unequivocally that my right hon. Friend the Secretary of State for Wales will soon be advertising the posts of chairmen of the new health authorities in Wales?

Mr. Carlile: That is a small step for mankind and it is right that the trawl should happen in that way, but why not in England, too?

Mr. Malone: rose—

Mr. Carlile: I will give way in a moment. I seem to be drawing a chorus. Like two choirboys, singing seasonally, the Ministers come to their feet. Perhaps the Minister of State will tell us why every non-executive post on those health authorities should not be advertised.

Mr. Malone: The hon. and learned Gentleman should be aware that that is increasingly the practice. The availability of posts is advertised. The widest possible representation is sought among applicants, to enable the appointments to be made. That already happens in some

regions, especially in the south and the west, which I represent. It is an excellent practice, it is being encouraged and it will be expanded.

Mr. Carlile: I feel a little like a swordsman rather successfully drawing blood. Perhaps I should keep on this tack and in another 10 minutes we might have an announcement that all the posts will be advertised.

Mr. Bernard Jenkin: rose—

Mr. Carlile: I am sorry, but I must get on.
Will the Minister of State assure us in his reply that each authority will have representatives of the executive and medical, nursing and midwifery staff on its board, as well as consumer representatives, who might best be drawn from the community health councils that have been serving the public so well?
On consultation, will the Minister of State be able to assure the House that the authorities will be statutorily required to consult with community health councils? We face the threat of some health councils being taken out of existence as a result of the changes. The Bill requires at least one community health council for every health authority area. One suspects that that may mean that, in some areas, there will be only one community health council for that health authority area. I hope that community health councils will be consulted, and that we can expect to see very few reductions in the number of community health councils.
I was encouraged to hear what the Secretary of State had to say about universities. Eloquent representations have been made by the vice-chancellors, and in particular by the principal of St. George's medical school, Sir William Asscher. He has made the point that the regional authorities will, in effect, be replaced by regional outposts, which could mean that the influence of the universities will be reduced. All the research which universities do and the facilities they provide at the clinical frontier may also be reduced.
I hope that the Minister will be able to confirm that we will not simply have a token university representative in each enlarged region, but that the proportion of university representatives will be maintained in the new structure so that the extremely valuable quantum of their influence is not lost.
The next point I wish to make briefly relates to public health. Representations were made on that issue by Labour Members earlier in the debate, particularly by the right hon. Member for Derby, South (Mrs. Beckett). Public health doctors are concerned at the way in which the independence and discretion of members of the medical profession will be affected by the changes. Will they be able to speak freely on public health issues within the range of their responsibility, or will they always have to seek authority from the region—or possibly even from the Department of Health—before they speak on public health issues?
It is extremely important that consultants in public health medicine should have the liberty to express their medical opinion. There is a danger otherwise that the Government may naturally wish to play down a particular issue because of its political consequences, whereas public health specialists might wish to speak out to make the public aware of the medical consequences.
One way of dealing with the issue might be to require in the statute that each health authority should produce an annual report on the state of public health within its region, so that the public would at least be able to see the authority offering to make itself accountable on public health issues.
Midwifery has been subject to statutory supervision, which has ensured high clinical standards. At present, the regional health authority is the local supervising authority. The Royal College of Midwives has called for supervision to be retained on a statutory basis, and I hope that the Government will support and accept that call.
I suggest that the local supervising authority should be at purchaser level, so as to ensure the effectiveness and directness of supervision. In that context, will the Minister also tell the House whether the Government will retain maternity service liaison committees, which have served midwives and patients well?
I shall make a brief, but important, point about student nurses. It is right that nurse training has been improved, and that has been beneficial, but the Royal College of Nursing produced a survey within the last fortnight which showed clearly that many student nurses are simply not able to survive without working elsewhere during their courses. In many areas, it is extremely difficult for student nurses to obtain other work. The result is that student nurses—who work long hours and are gaining more and better professional qualifications—are being forced beneath the breadline. I do not think that we should be training nurses in that atmosphere.
Finally, I wish to mention the future of district general hospitals, and to do so I return to the speech of the hon. Member for Hereford. Hereford is a good example of a city with a district general hospital service—I shall leave the buildings out of it at present—which is extremely good. It does not provide the entire range of medical services, but the broad sweep is catered for by a competent group of clinicians.
The trend now, which one can understand, is towards emphasising centres of excellence, or specialist treatment centres—it does not matter whether they are in the public or the private sector—which provide good-value treatment in particular specialties. Those centres do, of course, have a role to play.
The Welsh Office Minister who is present tonight gave evidence to the Welsh Select Committee recently in connection with specialist treatment centres. In that evidence, he made the point that the percentage of treatment within the given specialty which the treatment centres in Wales provide is still very limited. I accept that that evidence is right, but the centres are a burgeoning trend.
There is a feeling in the national health service that the growth of centres of excellence may prove to be a threat to district general hospitals in cities such as Hereford. Ministers must watch closely as the situation develops. If district general hospital services are significantly reduced, we will inevitably see the closure of a large number of district general hospitals and, by that token, a reduction in services to the community. I hope that the Government accept that around every accident and emergency service there exists the need for a wide range of services which are best provided in a district general hospital.
During what I hope has not been too long a speech—I am the only hon. Member speaking for my party in the debate, Madam Deputy Speaker—I have sought to

highlight six specific points of concern to me and to my colleagues. I have studied both the Bill and the notes on clauses, and not a great deal of light has been shed upon the clauses as a result of that study. Some light may be shed upon those real live doctor-patient issues by the Minister in Committee. Just a little chink of light when the Minister comes to sum up the debate tonight would be much appreciated.

Mr. Peter Atkinson: The lack of passion from Opposition Members during a debate on a matter that I always thought they claimed as their subject has been remarkable. Indeed, if one looks around the House tonight, one can see three Labour Back Benchers and three Opposition Front-Bench Members in their seats. That is extraordinary from a party that always says that it makes the running on health.
The reason for the lack of passion is that the Opposition are concerned where to step, because they know perfectly well that they have no real policy on the subject. They also know that the Labour party is moving slowly, steadily and inexorably towards an acceptance of the Government's health service reforms. It cannot do anything else, because—despite the blustering of one or two Opposition Members—it knows that our health reforms are working and that the health service has improved out of all recognition from when the Labour party was last in office.
Why should not the Opposition accept our recommendations? After all, in recent months they have accepted a great deal of what the Government have done in their period of office. The Opposition appear to have accepted competitive tendering, privatisation and even educational league tables. Some Labour Members even accept the idea of opted-out schools. It is inevitable that the Opposition will slowly move towards an understanding that our reforms have been a success.
On a more serious note, however, if one digs deeper into the Opposition's lack of policy, the makings of a policy can be found. A clue to it can be found in the Opposition amendment, which refers to "regional public health directors" and their document, "Health 2000", published in February, which spoke about a possible regional form of health service.
We know that the Opposition are seeking to break up the United Kingdom. We have heard about a parliament for Scotland and what is called an assembly for Wales.

Madam Deputy Speaker: Order. I am not clear how those points relate to the Second Reading of a Bill.

Mr. Atkinson: If you will bear with me for a moment, Madam Deputy Speaker, I will prove how they do.
Just as the Opposition want regional assemblies for England, so they propose their form of regional health authorities. That proposal would re-politicise the health service, when the Government have successfully de-politicised it. Such a shift is extremely important.
I served on a district health authority for some years in the bad old days, when the DHAs were dominated by local councillors or the placemen of local councils. I must admit to being one of those placemen, because a local authority put me on a health authority board.
At the time, I had scant knowledge about the health service, but I am pleased that it is now run by professionals rather than those who were appointed to DHAs to politicise that service. That politicisation option had been proposed many years ago, but it had been rejected by the then Labour spokesman, Nye Bevan.
The result of the politicisation of the health authorities was quite appalling for patients, especially in regions dominated by the Labour party. Those Labour DHA members had at heart not the best interests of patients, but those of the unions and union members. Labour councils also appointed health workers from one DHA area to sit on the DHA of another. They were not interested in looking after the interests of patients; what mattered to them was looking after the interests of their fellow professionals by adopting a "make work, improve conditions" attitude.
Those DHAs resisted the closure of redundant 19th-century hospitals which should have been closed down years ago. They also opposed root and branch any form of contractorisation or tendering for hospital services. I remember that, when my local DHA eventually succeeded in privatising the cleaning services for one hospital, we were amazed to discover that that hospital worked on a 30 per cent. daily absentee rate. The contracting out of services revealed such arrangements.
In those days, we had to work with COHSE, the health service union. A greater misnomer for a union one could not find, because that union continually reduced hospitals and their patients to misery through regular strikes at hospital laundries. That action was one of the union's favourite tactics. That union now represents itself as a new union, Unison, but I am sure that its agenda is the same as that pursued in the old days.
One of the purposes of the RHAs was to sort out the mess caused when local authority boundaries and health authority boundaries were coterminous. That problem arose because of early reforms to the NHS in the 1970s. In those days, patients did not travel within their local authority boundary for treatment but continually crossed to where their doctors wanted to give them treatment, or where those patients wanted to be treated. The RHAs therefore had to have enormous financial departments to sort out the mess caused by such cross-boundary treatment.
All those problems have been resolved through our creation of hospital trusts. That is why it is perfectly timely for the top layer of bureaucracy in the health service to be abolished. I must commend, however, what RHAs have managed to achieve in recent years.
If I may be parochial for a moment, I am pleased that the headquarters of the Northern RHA will be relocated in Durham, rather than in Harrogate, as has been argued for today by some hon. Members. Durham

is the convenient choice, because it is in centre of the region. That RHA has offered an innovative solution to a problem involving my district general hospital.

Mr. Bayley: Without becoming too parochial, is the hon. Gentleman suggesting that Durham is equidistant between Newcastle and Grimsby, which will be within the same RHA?

Mr. Atkinson: Given that the new authority will include Northumberland, Cumberland, Durham and parts of North Yorkshire, I believe that Durham is conveniently close to the centre of that region and has good road links.
My local RHA offered an imaginative solution to the problem posed by Hexham district general hospital. The solution may interest the hon. and learned Member for Montgomery (Mr. Carlile), who might be faced with a similar problem in his constituency.
The small district general hospital at Hexham is rather archaic—it was built as a temporary hospital during the war—but it serves a large rural area, and is loved and appreciated by local people. The difficulty was that the hospital could not provide the wide range of services, expertise and specialties that are available in major teaching hospitals and major city centre hospitals. The RHA's solution was most effective, because it welded Hexham general hospital into a joint trust with the Royal Victoria infirmary of Newcastle, which is one of the leading teaching hospitals.
As a result of Government reforms, consultants from the Royal Victoria infirmary are now able to travel out to the district hospital to carry out operations. That change will bring the expertise of that major teaching hospital to the district hospital. I hope that the Under-Secretary of State for Wales, who is on the Front Bench now, will pass on to his colleagues at the Department of Health our optimistic hope that a new district hospital will be built on the existing site in the centre of Hexham.
The RHAs have run their time. They served a necessary and useful purpose, because, in recent years, they have been helpful in establishing the reorganisation of the NHS. The final reform proposed in the Bill will ensure proper independence for the trusts, better financial savings and a better service to patients.

Mr. Hugh Bayley: So far, hon. Members have addressed the issues of bureaucracy and accountability. I accept that they are important and central to the Bill, but the most important issue is whether the abolition of RHAs and the merger of FHSAs and DHAs will improve the health of the people.
The most fundamental principle of the NHS is that of equity—that patients, irrespective of where they live, should be treated on the basis of need and on their ability to benefit from health care. That is the absolute hallmark of a public-sector, tax-based health system—a system into which we all pay and from which we can all draw health care, when we need it, on the basis of need.
Under the Conservative Government, however, evidence has grown of stark, widening inequalities in health, both between different regions in the country and between different social classes—inequality in terms of access to health care and in terms of people's state of health.
Evidence of that appeared many years ago in the Black report, which was commissioned by the then Labour Government, but buried after the 1979 election by a Conservative Health Minister. The Select Committee on Health has also taken evidence of health inequalities. For instance, in our recent study of dental services, we learned that five-year-old children in Scotland, Wales and the North Western RHA had twice as many decayed, missing or filled teeth as children in the West Midlands, South West Thames or Wessex RHAs. What is more, the average number of decayed, missing and filled teeth is actually increasing in the poorest regions of the country, whereas it is decreasing in the richest region of the country.
There are disparities not simply between regions, but between social classes. In the Health Select Committee, we were told that adults in social classes IV and V, unskilled and semi-skilled manual workers, when compared with those in social classes I, II and IIIa, white collar workers, had more missing teeth and more than twice as many decayed teeth, but fewer filled teeth, showing a lower level of treatment.
Quite recently, in April 1994, an article by Peter Phillimore and others in the British Medical Journal identified the health inequalities in the Northern region. They found that adults aged less than 65 in the more depressed parts of the region, such as St. Hilda's ward in Middlesbrough or West City ward in Newcastle, were four times more likely to die—they had four times the standardised mortality ratio—than people living in more prosperous parts of the region such as Wylam ward in Tynedale or Whalron ward in Castle Morpeth. In other words, health inequalities are literally a matter of life and death.
The problem of regional inequalities was first tackled in 1976 by the last Labour Government by introducing the resource allocation working party, which funded regional health authorities on the basis of the populations in the regions weighted by death rates in those regions. That basis of funding the national health service has continued ever since.
However, the abolition of regional health authorities as a result of the Bill means that a new funding formula would be needed, because one can no longer fund on the basis of regions. Therefore, last year, the Department of Health commissioned research from a group of health economists at the university of York, to develop a new formula to fund district health authorities.
The researchers found that the current formula underestimates the need for health are in deprived areas, principally in the north of the country and in inner cities, because it takes no account of the health implications of social deprivation. They found that indicators such as unemployment, the proportion of the population who are lone parents, the proportion of elderly people living alone with no carer, and the proportion of ethnic minorities, were good indicators of the amount of health need and the resources required to meet it.
The York research team published its findings in the British Medical Journal on 22 October 1994. It estimated that, using its formula, the Northern regional health authority should receive 2.8 per cent. more in relation to acute care to meet the health needs of the population in the Northern region, compared with the health needs of populations elsewhere in the country. By contrast, the

team found that, as far as acute care is concerned, the Oxford regional health authority received 4.8 per cent. more than its entitlement on a needs-based assessment.
The team also produced a formula for the provision of services for mentally ill people. It found that the North East Thames region received 15.4 per cent. less than its entitlement for psychiatric services, and that the Wessex region received 17.5 per cent. more than its entitlement when the health needs of the population in the region were taken into account.
The day before the researchers published their results—perhaps the timing was co-ordinated—the Department of Health issued a letter to all finance directors in the national health service in England, departmental letter FDL (94)68, which accepted the main thrust of the York researchers' argument and said that it would apply the York formula to the majority of the NHS budget. The Department made some modifications, but it chose the York formula as a basis for the new allocations to health authorities.
It therefore shocked me to find out last week, from a Department of Health press release, that next year's resource allocation to the health service provides exactly the same 4.4 per cent. increase for each regional health authority, irrespective of the health needs of the population in the region. That will perpetuate the health inequalities I mentioned earlier, and will undermine the principle of the NHS as a national health service, meeting the needs of patients equally, whether they live in Newcastle or Bournemouth.
The difference that funding on a straight percentage basis for each regional health authority in the country makes, amounts to very big money. With the help of some of the York health economists, I have calculated over the weekend the target allocations for each regional health authority if the York formula, which the Government have said they will accept, was implemented on the modified basis that the Government laid out in their letter to our health service finance chiefs.
Compared with the actual allocations that the Secretary of State announced last week, the new combined Northern and Yorkshire region will receive £128 million less than its target, according to the formula that the Government say they will apply. The North Thames region will receive £103 million less than its entitlement under the formula that the Government commissioned, and which the Government say that they will introduce.
By contrast, the South and West region will receive £40 million more than its entitlement based on the health needs of the population in that part of the country, and the Anglia and Oxford region will receive a massive £286 million more than its entitlement based on the health needs of the population in that area.
I do not argue for swingeing cuts in the health service in the south. However, if the Government wish to provide a comprehensive health service which provides equal access to treatment for people throughout the country, they should be moving towards the allocation of resources based on health needs. They need a strategy for gradually correcting the imbalance in resource allocation that favours the south at the expense of the north, and this year they had the opportunity to do it.
The press release last week, announcing the Department of Health's allocation for this year, said that the allocation amounts to a 0.85 per cent. increase in


addition to the rate of inflation. Significant new money is going into the health service, and that new money could and should be targeted on the regions that are underfunded at present.
If one draws a line across the country from the Severn to the Wash, according to the formula that the Government themselves commissioned, north of that line the national health service receives £235 million less than its entitlement based on the population and the needs of a population; and south of that line the NHS receives £235 million more than its entitlement based on the needs of the population.
That is unfair; it is unjust. It is unacceptable to meet the health needs of people in the south by cutting the health care budget for people in the north. If we are to continue to have a national health service, health resources must be allocated on the basis of patient need for care, rather than party political geographical allocation, which benefits people living in Conservative parts of the country.

Mr. Bernard Jenkin: Following the hon. Member for York (Mr. Bayley), I am intrigued by his discussion of formulae and allocation. I have not studied the York formula, and perhaps he served warning on me, as a representative of a constituency south of the line that he drew from the Severn to the Wash, that I should study it, and with care, but I am bound to say that study of those formulae rarely repays the effort as much as one hopes.
We in the North-East Thames region have, for some considerable time, perhaps been over-provided as a region. The resource allocation working party set up by the last Labour Government in 1975 started to move resources for a fairer allocation across the country.
Within the North-East Thames region we have had lengthy arguments about the allocation of resources between the various districts. The most salient point to come out of the discussion about formula is the distorting nature of the regional health authorities. They have not just distorted the allocation of resources across the country—doubtless that argument will continue—but have distorted the allocation of resources within regional health authorities.
They have done so to such an extent that the national formula used by the Government to distribute resources across the regions is discarded by the regions, which use their own formula. That formula is perhaps closer to the York formula, which reflects social deprivation and other such factors. North-east Essex has thereby suffered a double whammy. We are losing money as a result of the resource allocation working party and the trend towards allocating resources out of the London area. We have been losing money again as a result of finances being concentrated in the London parts of the North-East Thames region.
Thankfully, the NHS reforms have, over the years, begun to resolve that problem. There was a wide differential between the amount of funding per head allocated to my constituents in north-east Essex and north Colchester compared with those in south Suffolk. As a result of the NHS reforms, that gap has gradually closed, and we are today much closer to attaining parity.
It is important that bureaucrats, whether in the districts or in the regions, are having less and less influence over the allocation of resources. As we see the growth of GP fundholders, as fundholders attract resources on the basis of their patient lists and their characteristics, and use that purchasing power—not just within the district where the district purchaser has purchasing power, but anywhere—we see developing an NHS that allocates resources more intelligently according to the natural signals developing in terms of the internal market. Resources are used more effectively and carefully by the GPs acting as advocates for their patients and allocating resources accordingly.
It is no surprise that the Labour party, for all its modernising tendencies, should oppose the Bill. It has opposed every one of our NHS reforms when we have produced them. We no longer hear the scare stories about NHS trusts leaving the NHS. The Labour party is no longer able to make that charge, because it is ridiculous. No doubt the Labour party will make ridiculous and equally fallacious charges about the Bill. As my hon. Friend the Member for Hexham (Mr. Atkinson) said, perhaps the Labour party will eventually come to the same view on the Bill as it did about education league tables and grant-maintained schools. We expect the argument to continue to advance in our direction.
The achievements in my constituency as a result of the NHS reforms have been considerable. All our provider units, to use the jargon—most people still call them hospitals—have moved towards NHS trust status. As a result, our acute unit has been able to expand and use its resources more efficiently. We have opened a day surgery centre and new surgical wards. It was recently announced that the unit's facilities will be further expanded to include a day surgery.
That is not to say that those who work in Essex Rivers Healthcare do not have to work extremely hard, often under adverse conditions. We ensure that the money goes as far as it can. I pay tribute to all who work in Essex Rivers Healthcare and give them my moral support. We must not ceaselessly take advantage of the good will of those who work in the health service.
Perhaps one of the benefits of the continuing devolution of decision-making power in the NHS is that one day we shall get rid of the old Whitley council arrangements for negotiating terms and conditions. We could then apply much more modern terms and conditions, with better pay for those who most deserve it, rather than being hidebound by the existing bureaucratic pay and negotiating structures.
Essex Rivers Healthcare has to cope with discharge policy in the face of what my hon. Friend the Member for Colchester, South and Maldon (Mr. Whittingdale) mentioned—the failure of Essex county council's policy on community care. Despite there having been a 66 per cent. real-terms increase since 1991 in the funding of community care in Essex county council, the Labour party has cocked it up—not to put too fine a point on it.
That just shows that, for all the caring good will—I am sure that those involved are nice people who care—they are incapable of delivering the policies that people expect and on which the most vulnerable in society depend. That inability has a knock-on effect in the NHS, and ultimately places a strain on the good people who work in the Essex Rivers Healthcare who have to make decisions about discharging patients. It is rich for the Opposition endlessly to say that they would look after the health service better


than we do. That is another example of Labour policies, even in county councils, having a detrimental effect on the NHS.
The mental health services in Essex took on NHS trust status soon after the NHS trusts were first announced. We have a trust called New Possibilities, for people with learning disabilities. All the NHS trusts have become innovative examples of what can be achieved. The New Possibilities trust has started an employment agency specifically for people leaving the old-fashioned system of care under the health service. It moves people into the community and ensures that they find a job. That is an example of innovation that we should surely support.
We also have large numbers of GP fundholding practices that greatly benefit patients in the district. My constituency contains the first single GP fundholder. I urge the Government not to dismiss such innovation. In the initial study, single GP fundholding practices were found not to be cost-effective, but that was because they were given the same start-up funding as multi-GP fundholding practices.
Although I am certain that the money may have been put to good use, surely a single GP setting up as a fundholder does not need the same start-up money as a multiple GP practice. That must have had a detrimental effect on the cost-benefit analysis of the study. I urge Ministers to continue to study single practice GP fundholders—a good innovation that works extremely well in my constituency. I wish that we had more of them.
The abolition of the regions is a natural consequence of the NHS reforms. The existing regional structures have done good work over the years, but are part of the old command and control system—the Stalinist system, as my right hon. Friend the Secretary of State called it. That is no longer necessary, as so many decisions on the allocation of resources at local level are now taken at local level.
Opposition Members often criticise the rise in bureaucracy in the NHS, but the new policy gets rid of bureaucracy, and it is entirely natural that we should have moved some of the bureaucrats out of the regions and districts and into the hospitals and GP fundholding practices where the decisions are made. It naturally follows that we need to cut out the bureaucracy that has now become obsolete.
It is only natural that people sitting behind rows of desks in large office blocks feel that they are doing useful jobs; perhaps they are, but they are not as useful as they used to be, and they are certainly less important now.
I confess that, on my one visit to the headquarters of the North East Thames regional health authority, I was staggered by the size of the building. I lusted after the time when we would have NHS trusts all over Essex taking the decisions, and we would be able to get that distant London-based bureaucracy out of our hair. That has now happened, and we are better off as a result. We do not need regional interference in local policies of the type from which we used to suffer. The job of the regions is obsolete now that we have the trusts.
The development of specialist services is no longer planned by the regions in the way envisaged when the RHAs were first established. The Opposition amendment obliquely mentions cancer services. Decisions about cancer provision and anti-cancer strategy are being made now by the London implementation group, which is

taking a more keen look at the general provision of cancer services across the regions—a view that a single region could never enjoy on its own. A much more co-ordinated approach is needed. We are moving towards a health service that takes the day-to-day decisions at a level ever closer to the patient; and strategic decisions are planned unashamedly strategically.
Although this may raise bogus fears about accountability, the only accountability that really matters is to the patient, when he or she gets the treatment required. As a party, we are happy to remain accountable to the British people. If they are not satisfied with the service, no doubt they will say something about it at the general election.
All the evidence shows that patient satisfaction has improved. Of course, Opposition Members go on talking up what usually prove to be false fears about the state of the health service, but more patients are being treated and are satisfied with that treatment. If one asks an ordinary person what he thinks about the state of the health service, he will pick up the adverse vibrations sent out to him by—usually—an Opposition Member. If one asks him, however, about his own doctor or hospital, he will say what marvellous treatment he has received at their hands.
Accountability brings me to the membership of health authorities. I am very pleased that, once again, Ministers have made it clear that we are not going back to the argy-bargy political meetings held by the old-fashioned health authorities at a time when people were appointed to them as part of the process of handing out the political spoils of office to councillors. People used to end up arguing about the PLO and many other things that had nothing to do with the health service. The real decisions were not made, and if they were made, they were made far too late.

Mr. Nicholas Brown: rose—

Mr. Jenkin: I am not giving way.
The internal market in today's health service provides the information that is needed to make decisions in the service which allocates the resources. This Bill is a natural consequence of the continuing and successful reform of the NHS, and I commend it to the House.

Mr. John Gunnell: I am one of the few Opposition Members to have served as a member of one of the new health authorities. I should like to assure my hon. Friend the Member for Nottingham, East (Mr. Heppell) that I was not appointed because of my support for the Tory party.
My second relevant experience lies in the fact that I, like those who work for the RHAs, was once abolished. I used to be the leader of a metropolitan county council, but then I was abolished, and the father of the hon. Member for Colchester, North (Mr. Jenkin) had a hand in that.
My third relevant experience—the most important one—has come during the past two and a half years of handling queries from constituents. Conservative Members may say that constituents are always complimentary about the nursing care that they receive and so on, but hon. Members are also brought a great many cases of real difficulty. I know of a whole series of such cases, of which perhaps the worst was the one that I


cited earlier—the person whose operation was stopped after he had been anaesthetised. Such cases lead me to comment on this Bill.
I oppose the abolition of the regional health authorities, not from dogma but because I think that abolition will bring to the health service two things that we could do without: centralisation and fragmentation. One result of abolition will be that the strategic planning of the service moves from tie region to the centre. My hon. Friend the Member for Nottingham, East pointed to the number of functions that the regional offices will continue to carry out.
The difference between the regional offices and RHAs is that the former are accountable upwards, to the NHS executive and to the Secretary of State, but they contain no members who are accountable to other bodies. The current RHAs may have been accountable only in a limited way, but at least there was more downward accountability. That means that strategic decisions will henceforth be taken out of the public eye, because they will be made exclusively in regional offices.
This, too, is very like the abolition of the metropolitan counties. A whole range of decisions previously taken by those democratically elected bodies moved away to regional offices and were taken by regional civil servants.
There will also be less coherence of service within a given region—that is where the fragmentation comes in. At present, RHAs at least consider the context of a region generally. With a series of separate authorities, there will be fragmentation, making it even harder to achieve an equitable distribution around a region. My hon. Friend the Member for York (Mr. Bayley) has already pointed out the inequity of that distribution.
Furthermore, some services will be dumped when the RHAs disappear. They will disappear without trace—another striking parallel with what happened when the metropolitan counties were abolished. Some services, such as the Crown Prosecution Service, were immediately centralised; some remained in a recognisably accountable form. But the powers of such bodies—the joint boards for police, fire and public transport—were gradually whittled away, and smaller, specialised services were lost. That happened not because the powers to promote, say, an archaeology service disappeared, but because the authorities responsible for such services had no money with which to perform them.
The greatest loss, however, was the loss of accountability.

Mr. Michael Trend: The hon. Gentleman has made the rather serious allegation that some services might be dumped as a result of the Bill. Would he care to give us an example?

Mr. Gunnell: I shall shortly be offering a quotation precisely with that in mind.
I should like first to deal with the money that it is claimed will be saved. There is not much evidence that the £150 million savings have been thought through. The abolition of the metropolitan counties was based on the idea that enormous savings would accrue. Research showed that there would be no savings before or after abolition. The savings argument was bogus. We shall be surprised if any savings as a result of abolition go to the care of patients.
The region is not being entirely discounted. Under the process of accountability each region will be represented by one person, a respected local figure, and he will somehow be responsible for that region. How can one person take that on and be a respected local figure in the whole of the Yorkshire and the northern region? It is facile to say that such appointments will not be political because the eight people who will represent the regions will be on the policy forum at the centre and will inevitably be members of the Conservative party.
My experience of being appointed to an authority as a Labour party member was interesting. I was invited to meet the chief executive of the health authority and he asked whether I would be willing to serve on it. He knew my background and where I stood politically. I had many commitments at the time so I said that I had doubts about serving. I had been asked to serve because I was a member of Leeds city council and I suggested that another member of the council might be willing to serve. I was told that only three members of Leeds city council were acceptable. I am not sure what that made me.
One of the three was already on the regional health authority and another was on St. James's hospital trust. That left me and I was told that if I did not take the job there would be no representation from the city council. I discussed it with the leader of the council and we agreed that it would make sense for me to become a member of the health authority and chairman of the social services committee. It was clearly seen as a political appointment, and it is facile to pretend that such appointments are not. That is not to say that they are all political appointments, but the eight people who will be regional bosses will be the ears of the Secretary of State, and those ears will be very sensitive to the policies of the Conservative party.
There are non-political appointments to health authorities. I was one, and it is the job of people on such authorities to make them work. The new health authorities are probably not as bad as we say and not as good as the Government make out. One specific achievement by Leeds health authority which was brought about by the reforms is that before the reforms it was almost impossible to get an abortion in Leeds. As soon as the providers found out that there was income to be had from abortions, they became available in Leeds, and that was a welcome change.
A fellow member of Leeds health care was a non-political appointee. He is David Hunter of the Nuffield Institute for Health at the University of Leeds. In the research paper provided by the Library, Mr. Hunter states what would be lost when the regional health authorities were abolished as:
arbitrating in local disputes; providing a challenge to local myopia in service development and commissioning; encouraging innovation and new ways of doing things; and promoting health strategy development, community care and priority services, research and development, and health alliances. In theory, purchasers and providers ought to be able to inherit such an agenda. In practice some will but many more won't.
I have two questions about the changes and the merger between Leeds and Yorkshire. Why Durham? No contracts have been let because a site has not yet been chosen. However, £2 million has been spent on the centre in Harrogate to bring it to a high standard. Was that taken into account when the issue was discussed and studied?
Under the Minister's proposals, Quarry house in Leeds will lose 200 employees, which is, I think, 21 per cent. of its staff. A tremendous amount has been spent on Quarry


house and if 200 staff are going there must be space for 135 from the new regional health authority without having to build anything extra. Have the Government considered the costings and found that it is cheaper to construct a new building in Durham than to use the space that they have created in Leeds by partly emptying Quarry house? The sums do not add up.
We oppose the abolition but look somewhat favourably at the merger of the district health authority and the family health services authority. As the chairman of the social services committee in Leeds I have worked with both authorities and to me it makes a great deal of sense to put responsibility for primary and secondary care together.
Why will fundholders be more directly linked to the regional offices than to the new authority? The authority should be responsible for fundholders as well because if it is not that will perpetuate the current inequity. Conservative Members have not answered our questions on purchasing. As the numbers of fundholders increase, the purchasing role of health authorities will decrease. By acquiring primary care they have obviously increased their purchasing powers a great deal. Will health authorities still have a real role in that context?

Mr. Michael Trend: I welcome the Bill and the overall progress of the Government's health reforms. I recently had the honour to attend an international conference at one of the royal colleges at which people from health services all over the world were gathered. It was clear that our health reforms were in the international league and that other countries were looking to us with our experience. Not all of them had done what we have done, and the United States was on a completely different tack.
Fundamentally, the reforms are held together internationally by the purchaser-provider split, which was pioneered in this country and has made a real contribution to creating an excellent health service that the country can afford.
The Secretary of State spoke about the OECD report. It states:
The command and control system of the NHS lacks flexibility, incentives for efficiency, financial information and hence accountability and choice of providers of secondary care.
The health reforms have been widely praised and I also commend them. We began by addressing the trusts and fundholders. That is evidence of the Government's desire to have a more locally based national health system. Had any Government wished to create a centralised system they would have started by reforming or strengthening the centre. That was not what happened. First, more local systems in hospital and primary care were set up, and that shows the emphasis of the Government's reforms.
While that was going on, some people thought that the purchasing side of the equation was in danger of being left behind. Purchasing is central to the NHS. We have heard much about the so-called centralisation of the NHS through these reforms. Does the Bill centralise? I do not think that it does. It removes a vestige of the command and control system. It is extremely important that we understand that the new NHS will be based, and will be accountable, locally.
What about accountability? The present system is working well in both trusts and fundholding. It is part of the evidence that we need to examine to ensure that

accountability is secure. As many of my hon. Friends have already said, we do not want to politicise the NHS, its management or its accountability. We must not forget community health councils, which are the voice of local people. I understand that their position remains unaffected by the Bill.
I am not at all sure about Labour's regional plans. The right hon. Member for Derby, South (Mrs. Beckett) did not clarify its plans for regional health services. I suspect that she is trapped in the difficult logic of Labour's proposed governmental reforms—perhaps having tiers of regional government throughout the country—and she may want some conterminous boundaries between regional government and regional health authorities.
This is a debate about health services in the regions. However, I advise the Labour party to think carefully about its general plans for rearranging local government, or even central Government, on a regional basis. I do not think that the people of England would have any fondness for an end to their traditional national form of Government in favour of the imposition of new regional forms. It is a big can of worms for the Opposition. From the West Lothian question down to the English regions, it will provide a big headache for them in the months and years ahead.
I want to say a few words about the formal relationships outlined in the Bill. First, when the new health authorities come into being, they must respond to what Ministers want in the development of the NHS. There will be a conduit of organisation coming down from Richmond house through Leeds to the new outposts, to trusts and on into the primary system. The means to achieve that must exist.
Secondly, the new authorities must be effective. They must be able to do well the job that they have been given to do. They must be efficient and economical and able to direct scarce resources to the areas where they are most needed. Thirdly, they must be responsive to the local environment. It is extremely difficult to legislate for that, so I shall instead comment on the informal relationship that the Bill will establish.
Health authorities have not always been responsive, but that is not the same as saying that they have not been accountable. The lack of responsiveness has arisen out of the old command and control structure. There needs to be a culture shift within health authorities. I shall give an example from my constituency. A distinguished local hospital—the Edward Windsor belongs, together with two other hospitals, to the local community trust. Last year, satisfactory plans for its future were proposed by the East Berkshire health authority. Shortly after that, the East Berkshire and West Berkshire health authorities amalgamated to make one Berkshire health authority.
The new authority had different priorities and plans for health care provision in my part of the county. The new plans were not nearly as satisfactory as the ones that they replaced. One proposal was to remove the world-famous Prince Charles eye unit from the Windsor hospital. Another proposal was not to proceed with a number of elderly rehabilitation beds, which had formed part of the original plan.
There was a vigorous local campaign. I took part in it, as did the local newspapers. A large petition was presented to Parliament. Doctors, consultants and many other local people raised their voices. The significant factor was that no one appeared to be in favour of the


health authority's new plans. No voices were raised in its support. The negotiations that took place, which were chiefly between myself and the health authority, were protracted. I was learning as we went along, and I felt that the health authority was also learning. The current position is more satisfactory because the eye unit has been saved and there are to be new and expanded clinical services. However, we have not reached any agreement with the health authority about rehabilitation beds for the elderly and it has now postponed a decision.
My argument with the health authority was not a local argument in the sense that I was saying that we had to have that unit for Windsor, that it must not go anywhere else and that I was sticking up for my people. Of course there was an element of that—there always is. My argument was that the provision of care for the elderly, especially rehabilitation care, would be more appropriately placed in local community hospitals rather than in acute hospitals at some distance—sometimes a great distance—from people who wanted to visit their elderly and frail relations.
We took advice from the King's Fund and others on current thinking and conventional wisdom. However, an impasse was reached because the health authority held one view sincerely and deeply and we held another—based on professional advice, not just narrow local considerations. In such circumstances and where all the local voices are ranged on one side, it is important that a health authority responds sensitively to the concerns of local people.
The new health authorities, whatever they be—regional or district, of whatever type or composition—must listen more to local voices. I thought I heard that message clearly in the opening remarks of my right hon. Friend the Secretary of State. She said that there needed to be more flexibility—I think that she used the word "visibility". The health authority should be more visible. For example, we heard earlier about the chairman of a health authority who holds local surgeries where he is available for local people to meet him.
We also heard today about public meetings on health matters—I have been to some—where almost everyone in the room is a health professional of some sort or another. The health authority calls the meeting and it sends a lot of people to it. Nurses and doctors attend, as do local Members of Parliament and local councillors. However, to get the general public involved, even through the CHC, is extremely difficult. It is only when a specific case arises, such as the Edward VII hospital, that the public have an understanding of the issues involved. Therefore, there must be far more "visibility" by the health authorities. They must work with local people because they are working for local people.
We want a locally based NHS and I believe that the Government are delivering that through their reforms. We want that locally based NHS to be responsive quickly and with the minimum bureaucracy and waste. The Bill will help to bring about that desirable aim. However, if we go too far or too fast and do not take public opinion with us, and if the health authorities are not responsive to local voices, we will risk many of the benefits of our reforms coming undone.
It is most important that the public's confidence in the national health service is maintained at the highest level. Recent research shows that public confidence in the NHS is higher and growing. The Opposition say, on the one hand, that the health service is falling to pieces, but, on the other, that it is excellent. A constituent of mine, who I suspect is a member of the Labour party, also holds both views at once. He tells me that the health service is falling to bits, there is no care, and people are struggling in the streets and dropping like flies. He then writes to the local paper saying that he has been in hospital for a certain procedure and cannot not speak too highly of the doctors and nurses and the care that he received, and that he felt considerably better. I wrote to him and pointed out that that was excellent news and perhaps he would take a less jaundiced view about the health service in future.
Confidence must be kept high. It is important to ensure that our health authorities in both their formal structure, which makes them locally based, and the informal advice and encouragement which we give them to listen to local voices, are the way forward. None the less, this is a good Bill. It will be good for patients and the national health service, and I hope that it receives a Second Reading tonight.

Dr. Tony Wright (Cannock and Burntwood): This strange Bill is both short and long. Its substance covers but four pages, while its schedules cover some 50 pages. That shows that it is a framework Bill that takes powers. In this case, it takes powers to the centre where they can then be used in a variety of ways, to be spelled out later in secondary legislation. That is the kind of Bill which the Government favour. If the Bill is a culmination, as we have heard, it is a culmination of a whole way of legislating, in which one takes framework powers in a Bill like this and then backs them up with a battery of further powers in which the meat and substance are filled out.
In some ways, this is a fairly uncontentious and perhaps even sensible Bill. For many years we have discussed whether it is sensible to have regional health authorities, whether their function could be defended or whether the time had come to remove them. It is possible to discuss that sensibly. The problem is that it becomes a more apocalyptic story about a process of health service reforms, of which the Bill is said to be a culmination.
I shall ask three questions about that process of health service reforms. First, will it improve the quality of the service? I understand that that question is fundamental when we sweep aside some of the possible arguments. Secondly, will it improve the accountability of the service? Thirdly and more specifically, although it is important, will it enable people better to complain about the service if things go wrong?
On my first question, I hope that the Bill will improve the quality of the service, because, for a long time, many of us have thought that the way to improve the commissioning—we prefer to use the word "commissioning" than "purchasing"—of health care locally is to amalgamate FHSAs and district health authorities. We felt that the division was artificial and made local health planning much more difficult. The fact that that amalgamation is taking place is, prima facie, an argument for the ability to drive quality upward as a result. However, I put it in terms only of potential rather than achievement because a huge job remains to be done.
If the Government say that the health agenda is complete in that respect, I argue that it has only just begun. A range of issues to do with the quality of health care are untouched. It is only the precondition for a concerted assault on issues of health quality. I refer particularly to primary care, where FHSAs, or their predecessors, family practitioner committees, have had the sole function of paying cheques to doctors. They have had no effective function in monitoring the quality of primary health care and seeking to drive up its quality.
I hope that a consequence of that amalgamation will be to provide the armoury whereby that can now take place because there is a huge gap in our ability to achieve health quality. For example, in the past year alone an extremely good report has been issued by the director of public health for the South Staffordshire health authority. It identified for my area, Cannock Chase, a number of appalling and worrying developments. It showed that we had the largest number of single-handed practitioners, the longest lists in the district and the highest number of referrals from Gps to hospitals, which usually indicates problems in the quality of primary care.
I took those problems to the Staffordshire FHSA. The analysis was linked to other evidence, which said that the area had the most health needs. As we have more ill people in the area, we have a mismatch: the poorest quality of provision and the worst health. The FHSA is the notional provider of primary health care, so I presented the evidence to it and asked what it could do about it. The answer, essentially, was that it could do nothing. It could have conversations with doctors and watch, but nothing more. That is wholly unacceptable. We must work towards a position where those who pay for or commission primary health care have far more ability to watch, monitor and drive up the quality of that care. That presents a huge agenda, and I hope that it will be grasped.
On the issue of hospitals, the Government must grasp the problem in relation to clinical outcomes, audit and performance, which is a hugely neglected area. Many of the matters to which we have devoted so much energy over the years are of minor significance compared with those hard indicators of the quality of care—not what goes into the system but what comes out of it.

Mr. Malone: I am tempted to invite the hon. Gentleman to come and join us because he is pointing out that the new system can tackle those agendas in a way that the old one could not. It is particularly important that he realises that the ability of GP fundholders to respond instantly to the patient need which he has identified is one of the great benefits of the reforms that are now in place. I am sure that the hon. Gentleman will acknowledge that.

Dr. Wright: I am extremely grateful for the Minister's invitation, which is the best that I have had all day. Nevertheless, he rose a little prematurely, because I was about to add that, if that is common ground, as it should be, what should also be common ground is a serious attempt to look at inequities in health care. If that is not common ground, I simply ask the Minister to look at the evidence presented in last week's British Medical Journal, which brings together much of the contemporary evidence on inequalities in health care.
The professor who wrote the overview referred to the way in which "The Health of the Nation" devoted only one page to variations, not inequalities, in health among socio-economic groups, which are said to be the result of

complex factors. The British Medical Journal stated that it is inconceivable that changes in the genetic make-up of different socio-economic groups have occurred over the past 15 years to produce the increases and differences in mortality in Britain. That is an appalling and devastating commentary on 15 years of social and economic policies that have produced a massive deterioration in health equality.
We use terms such as "life chances" in a glib and easy way, but here we are literally talking about life chances, which have deteriorated in the past 15 years as the result of a so-called trickle-down policy that was supposed to make everything come good. It not only failed to come good but came bad in a big way.
Surely we could at least agree on health policy aims to reduce inequalities in health, then apply our minds to achieving those aims. Instead, we have failed to agree and the position has grown substantially worse. There is a huge agenda to tackle.
Will accountability be improved? Is the Bill a decentralist or a centralist measure? Regional health authorities play a role in protecting and sponsoring health authorities and now trusts. They perform a variety of useful functions, and one must question what will happen to some of those roles when regions are abolished.
Only last week, almost all the consultants at the Foundation Mental Health Trust in Stafford passed a vote of no confidence in its chief executive. That was a fairly dramatic occurrence and, by implication, a vote of no confidence in a rather ineffectual trust board. Those consultants were immediately able to seek the advice and guidance of the region, which acts as a buffer between the centre and the localities. When regional offices are no longer statutory offices with a status and integrity of their own but simply regional outposts, the relationship 'will change and roles will alter.
Reference was made to problems in relation to the regional director of public health. The service needs every independent voice that it can get, and the Bill will reduce rather than increase independence. As the former chairman of a community health council, I regret that CHC statutory rights in relation to proposed trusts are removed by the Bill. We should strengthen the role of CHCs, users and consumers—not weaken them further. Every time that I hear the statistical arguments that were made earlier, the more I become convinced that the NHS desperately needs an independent inspectorate that can produce reliable information of a kind that does not exist at present.
The most crucial aspect of accountability is the composition of the new health authorities. I return to the nature of the Bill, with its few clauses and vast number of schedules. It is extraordinary that a Health Authorities Bill should fail to answer the fundamental question of who will serve on the new authorities. Schedule 1 on page 19 of the Bill states only that there will be new health authorities, whose members will be appointed by the Secretary of State. Earlier, the Secretary of State told the House that they will be the best people. I have evidence of the best people who have been appointed to such bodies in the past, but Conservative Members might find it embarrassing if I presented it now.
The new bodies will be the key commissioning organisations for health care in local communities, but the Bill does not say who will serve on them. Recently, the House considered the composition of police authorities.


It would not dream of allowing those authorities to be established by a Bill without any indication of their composition, yet it is doing so in respect of this legislation.
Recently, the chairman of the Conservative party said that one could not have serving on health bodies people who were not in favour of the Government's reforms. That is preposterous. One wants people who are committed to the health service. It seems that to be passionately in favour of or passionately against reforms is cause for disqualification. One wants people with an acute sense of public interest, who will defend it and the NHS at all costs. The Conservative party chairman has stumbled into a miasma of patronage, without thinking of the implications of his remarks.
There is now a test of whether the Government are prepared to roll back their public appointments process. Of course we need an open system and a commission publicly to advertise such appointments so that anyone who has something to contribute can apply, and normal civil service criteria could be used for selection. Such appointments must be taken out of the orbit of ministerial patronage and put in the arena of public interest. No wonder that Professor Chris Ham and Professor Hunter in Leeds both concluded that the Bill looks more like a centralising than a decentralising measure.
The complaints issue, which surfaced briefly in the debate, is dealt with by the Bill only in terms of transitional arrangements, yet it is the Bill's biggest lacuna. On any reckoning, the present complaints system is a total mess. Sir Alan Wilson and his committee were asked to investigate that aspect as a matter of urgency a year ago. The committee reported in May and consultation ended in August. We were promised speedy action, but Professor Wilson is now expressing regret and disappointment that there has been none.

Mr. Malone: There will be action. We shall bring forward proposals once we have considered what must be done.

Dr. Wright: That is good to know, but I can only go on the present delay. There was a clear expectation that there would be such legislation as was required in the present Session. The present complaints system has been called chaotic by everyone who examines it—the health service ombudsman, Sir Alan Wilson, the National Consumer Council and the National Association of Health Authorities and Trusts. A report on the matter was welcomed and broadly endorsed by every relevant party.
The present complaints system undermines the most fundamental principles of the citizens charter in terms of speed, effectiveness and independence. It cries out for reform. This is a health Bill, but one that signally fails to take up the one option that would bring direct and immediate benefit to users of the service.
There is now a certain ambivalence in people's attitude to the health service, as hon. Members—including the hon. Member for Windsor and Maidenhead (Mr. Trend)— have pointed out. Why do they feel passionately well disposed towards the service, yet passionately ill disposed towards aspects of the way in which it is run? I believe—this is meant, in a way, to be helpful to the Government—that something approaching a crisis of legitimacy is currently evident.
My theory—it is no more than that—is that the recent explosion of complaints about the service is not simply due to the fact that there is more to complain about; that is an easy point to make. I think that at one time people were not inclined to complain, because they felt that it was "their service"—or rather, "our service". Now they feel that it has truly become "their" service. A real test of legitimacy must be applied to the Government's proposals, and I do not think that the Bill meets it.

Lady Olga Maitland: Throughout the debate, Opposition Members have carped and jeered at the NHS. I entirely endorse what my hon. Friend the Member for Colchester, North (Mr. Jenkin) said about people's responses to his questions about their experience of the services. I receive the same responses on doorsteps in my constituency. People tell me that they are worried about the health service, but when I ask them about their personal experiences, they always express gratitude for the care and support that they have received. When I ask, "Then why do you feel as you do?", they reply, "It is what they say on television; it is what those Labour party politicians say."
I am sick and tired of hearing a litany of disaster. I thought that it might be helpful if I quoted from the response to a questionnaire sent out by a GP fundholders' practice in my constituency, the Cheam family practice. That response is very revealing: 111 patients responded, 97 per cent. of whom said, interestingly, that they were entirely satisfied with the care that they had received. That is completely at variance with what the Opposition are trying to tell us.

Mr. Morgan: We surrender.

Lady Olga Maitland: I am delighted to hear it. I could take up hon. Members' time by going through the rest of the questionnaire, which contains many points that you
now beg me to mention. [HON. MEMBERS: "No."] You do not want to hear the truth.

Mr. Deputy Speaker (Mr. Geoffrey Lofthouse): Order. The hon. Lady must not keep using the word "you"; the Chair has nothing to do with this discussion.

Lady Olga Maitland: I stand corrected, Mr. Deputy Speaker, but there are times when I feel somewhat goaded.
It might be beneficial and educational for Opposition Members to hear a little more about the questionnaire, although originally I did not intend to impose it on the House. To the question
On entering the ward were you made to feel welcome?",
86 per cent. of patients replied, "Absolutely." When asked,
Were your family/friends made to feel welcome?",
98 per cent. said yes. When asked,
Did staff respond quickly to requests for assistance?",
82 per cent. said yes. When asked, "Were you given privacy?", 100 per cent. said yes. Again, 100 per cent. said yes to the question, "Was your linen clean?". There must be some sense of reality about the kind of patient care that is actually being delivered.
I welcome the Bill. At first sight, it might strike many patients as no more than an accountancy exercise; but many patients will benefit from it. Any GP's eyes will


light up when he sees how his practice will benefit. Let me focus for a few minutes on how the Bill will affect patients in my constituency. I see them as the VIPs who are at centre stage in the whole scenario; the Bill, after all, is designed to improve facilities in their daily lives.
My regional health authority, South Thames, is scheduled to disappear as a result of the reforms. I shed no tears, because my constituents will be better served without it. The RHA's staffing level will drop from 400 to 135: that number will form the NHS local executive branch. It does not take much imagination to see how local medicine could benefit from the value of 375 salaries.
Moreover, it is plain common sense to merge Sutton, Merton and Wandsworth district health authority with the family health services authority. It strikes me as perfectly normal for GPs to work in ever closer partnership with the district health authority, and from the same building. In this instance all parties will operate from Wilson's hospital in Merton: as a result they will be not a telephone call or fax away from each other, but literally just a step from each other's offices. Daily, regular contact to discuss mutual problems—particularly when the GP is playing an increasingly important role in managing patient care—can only benefit all of us. In short, we shall have a one-stop shop.
The new chief executive of the combined health authority will be Mr. George Gibson. He is enthusiastic about making the GP the key link in the whole health-care system—the gatekeeper, as it were, who will determine who gets what and where. His input will ensure personal involvement as well. In his health authority alone, as a result of the Bill, Mr. Gibson will have the means to allocate £1.5 million more resources to front-line patient care—for instance, X-rays for lung cancer, tests for breast and cervical cancer, the delivery of effective drug rehabilitation care, health promotion such as anti-smoking campaigns, especially among schoolchildren, and more community health centres, especially on low-income housing estates. Indeed, why should there not be more district nurses?
In the same mode, Mr. Gibson wants to provide more mental health care to help families who must care for relatives suffering from schizophrenia, Alzheimer's disease or deep depression. All those conditions impose great strain on carers, who badly need psychiatric nurses to be on hand. I hope that his "wish list" will bring on stream child and adolescent psychiatric services: such services, sadly, are needed more than ever as children suffer from the pressures of broken families and drugs.
GPs, in turn, would have more resources to earmark for primary care. There would be help for children with special educational needs, crucial speech therapy and more physiotherapists. Surely he should have the power to employ a full-time carer or nurse if that means keeping a patient at home rather than in hospital, which is costly and not always necessary.
I cite the example of a local case involving four people suffering from sickle cell anaemia, which is a painful and miserable illness. Between them they were in and out of hospital 800 days a year, and pain management was the main problem. It was common sense to employ a full-time nurse to look after them and to help them cope with the pain and provide the support that they needed. They were able to stay at home in familiar surroundings and hospital

beds were released for expensive acute care for others. I trust that the Bill will mean that more resources are made available to expand such services.
It must be right that a GP should have a direct say in all aspects of patient care. More important, he should be encouraged to take a more proactive role, even if that means attending refresher courses. He should also be coaxed into offering more services in his surgery and given the necessary resources to be able to do so. That should apply whether or not he is a fundholder, but, clearly, the GP who is a fundholder will have more say in how his patients receive the appropriate care and, in addition, will receive the benefit of the extra resources made available as a result of the Bill.
There are a number of enthusiastic GP fundholders in Sutton. However, there is anxiety to ensure that resources earmarked for primary care are ring fenced. That would certainly introduce the necessary discipline, especially where there is a temptation for a district health authority to become so immersed in its own spending plans that, despite the well-aired aims, GPs end up being sidelined.
My fundholding GP told me what the extra resources would mean to him. He would like to improve his premises so that he can deliver more surgical care. It is nonsense to suggest that patients should have to put up with what I experienced years ago when I had to attend out-patients at Bart's to have a boil lanced on my thumb. It should have been done by my GP in proper surroundings. In future, a GP should be able to deal with all manner of minor surgery from skin lumps and bumps and the removal of cysts to joint injections.
I know a GP fundholder who is also a fellow of the Royal College of Surgeons. Once a week he carries out a minor surgery list which could include the treatment of hernias. Much routine work could be delegated in this way. With the extra resources, a fundholder should be able to employ physiotherapists, dieticians and counsellors and social workers should be brought in to work closely with patients who need extra care and support.
If we were to stretch a point, we could follow the example of the general practice in Aviemore in Scotland which was visited by a GP whom I know and his teenage daughter. She had broken her arm while walking on the moors, but the fundholding practice had a 24-hour casualty service. The girl was X-rayed and made comfortable and only then allowed to go to a hospital in Inverness for an operation. Had she had a clean break, all the services would have been available in the plaster room for her to have been fixed up without having to go elsewhere. Would it not be marvellous if resources released for primary health care as a result of the Bill could provide such services? I have no doubt that rural areas in particular would benefit.
GP fundholders should have the power to insist that their patients are placed in single-sex wards in general hospitals if that has been requested. I welcome the written reply that I received today from the Minister in this regard, but I am not certain that the patients charter standards to be issued next year, which will require hospitals to inform patients in advance when they will be accommodated on a mixed ward for non-urgent treatment, will be entirely satisfactory. The reply does not make it clear what patients can do if they find the arrangements unacceptable.
Is the onus on the health service to comply with the patient's requirements if a single-sex ward is not available immediately? I hope that, when establishing their contract with local hospitals, fundholding GPs will make it a condition that patients's concerns will be top priority and that they will not be exposed to embarrassment and forced on to a mixed-sex ward. There has already been some publicity about the issue, but it is not only women who are worried—I am told that men, too, are not always keen to be on a mixed ward.
I heartily welcome the Bill. It may not hit the headlines, but the result will be that patients, at their most vulnerable, will benefit most. It is disappointing that the Opposition cannot bring themselves to support it wholeheartedly. The Labour party's proposals will rebuild overloaded bureaucratic structures, and pressure groups will have their say at patients' expense. Throughout the debate Labour Members have demonstrated their obsession with political appointments. Under a Labour Government, the health service would go back to the bad old days.
I am delighted that the Bill deals with the real world. It will become law and provide improved services which patients need so badly, while Opposition Members bicker about how they will increase NHS bureaucracy. I doubt that patients will thank the Labour party for putting jobs for the boys first.

Mr. Kevin Hughes: Contrary to what the Secretary of State for Health and her colleagues have said in the debate, the Health Authorities Bill represents yet another blow against accountability, which has been attacked consistently throughout the Government's reform of the health service. Accountability must play a part in the provision of health services. However, with this Bill the Government are running away from accountability yet again and making the system less responsive to people's needs.
Accountability is essential because it is the only way to ensure that patients' interests come first. As a result of the internal market process, emphasis on cost cutting is defining priorities far more than the wishes of patients. Services are being planned by accountants and business managers whose priorities are financial and have nothing to do with the caring professions or with patients.
Under the Tories, business has taken over from service in the national health service. Patients have become "consultant episodes" rather than people. Applications for new equipment have become "business cases" to be negotiated with the private sector. In meetings, local health service managers talk about "strategic directions", "over-performance", "under-performance", "outturns" and "contract monitoring". They have figures and tables for everything—although most of them are designed so that no one, apart from the author and a chosen few insiders, can understand them. Bureaucracy has gone mad under the Tory Government.
In the current dispute over local pay, doctors are putting in about an extra 14 hours per week performing management tasks, including preparing invoices on patient charges, drawing up contracts, assessing prices and talking to managers. The public can ask legitimately: why are doctors not treating patients in that extra time?
Yes, patients are suffering. Last week, one of my constituents was told that he would have to wait for months just to obtain a consultant's appointment. He was also told that he would have to wait about two years to have a very painful cyst removed, even though the doctors knew that the man's employers had threatened to sack him if he did not receive treatment, because he could not continue to do his job in his present state. However, my constituent was told that if he could pay for the consultation—if he could find £50—he would be seen by the same consultant almost immediately. That is privatisation by the back door, and the Government know it.
The Bill further undermines the role of doctors and nurses in the decision-making process. It drops the duty to recognise local advisory committees of clinicians. It gives no details of any seats on health authorities that will be designated for medical staff. How will their expertise become part of the decision-making and oversight process? I know from my experience in social services that finding out about the practical problems and taking a practical approach to their resolution is essential if management are to be effective in securing improvements in services at the point of delivery.
Staff are a part of the accountability equation. Some months ago, a report by the health advisory service on mental health services in Doncaster was published. One of the problems clearly identified was the lack of consultation of staff and the lack of weight given to their opinions by management. If there are no clear lines of accountability in the NHS, that situation will be duplicated throughout it, with the inevitable consequences for planning, for the efficient use of resources and for patient care which flow from such failures. The report also found that a number of service users and their groups felt that the consultation was superficial. Clearly, people who matter are being excluded from the decision-making process.
The Bill is yet another example of how the Tories treat the NHS as just another business venture. Maples was right. The Tories will never win on the NHS because they will never learn that co-operative, collective action works and that people are central to success. They can only understand competition, selfishness and market forces. They do not understand that the NHS is staffed by people, that the services are delivered by people and that the patients who are treated are people. We are not dealing with machines making goods. We are dealing with people treating people and with the need to get the very best from the highly trained and skilled people in the NHS. The Government's approach, which undermines the rights of staff and patients, will not achieve that.
The Secretary of State says that a light touch is needed. That can only mean limited co-ordination and a lack of accountability which will prove damaging in the long term. The new regional executive offices should not be centralising bodies which consider themselves to be responsible to the centre. If that happens, there will be a lack of oversight and the loss of a strategic, regional, co-ordinated approach. We shall be left with an even more fragmented health service than we have now. The Government have put in place a system of mini-health businesses which are run by their sycophants at local level. Locally negotiated pay will take us further down


that road. As the Government move to complete their reforms with the Bill, fragmentation of the service and privatisation by the back door will continue.
The Government now propose that the health care function of the Department of Health should be run by the NHS executive, which will take full responsibility for the NHS. The executive will thoughtfully help Ministers with parliamentary accountability. Presumably the executive will give them their lines to read at the Dispatch Box, as usual.
Another aspect of the proposals which suggests that someone in the Department of Health has a healthy sense of irony is the announcement that the Bill will reduce the costs of management in the NHS, a view parroted by the Secretary of State today. Surely that is a joke too far. Since the introduction of the reforms, in Doncaster alone administration costs have risen from £4 million to £6 million, a rise of 48 per cent.—[Laughter.] Conservative Members may think that that is funny; I certainly do not. Patients are entitled to know why that money is being spent on administration in Doncaster.
That figure is completely separate from the 300 per cent. rise in managerial costs locally. Yet the Government expect £150 million to be released for patient care as a result of the changes. They are living in cloud cuckoo land. How can the Secretary of State, who has presided over such a massive explosion in NHS bureaucracy, tell the House with a straight face about the merits of reducing costs to plough money back into patient care?
The Government do not—and, I suspect, dare not—say how they arrived at that £150 million, which is perhaps why they seem confused about how much, if anything, will be saved. If the changes follow in the tradition of the remainder of the Government's reforms, we can expect a vast increase in costs and bureaucracy. We shall find that health authorities have to take on some of the region's functions, but they will do so less effectively because of their lack of expertise. There will be local duplication of some of the work previously done by regional health authorities, and costs will undoubtedly increase as a result.
Frankly, I do not believe the Government's claims about the national health service. They perversely attacked it for inefficiency and waste, but then created a new system which put incredible bureaucracy and waste in its place. Their claims about bureaucracy are not credible, just as their claims about waiting lists are not credible and were exposed earlier in the debate.
The Government's business-oriented and competitive approach to the national health service is fundamentally flawed because their ideology is wrong. I look forward to kicking them out of Government so that we can build a national health service based on socialist principles, which mean that people come first.

Mr. Nicholas Brown: The Bill was presented to the House as bringing to a natural conclusion the Government's health care reform agenda. The end result is supposed to represent the Conservative party's vision of a national health service safe in their hands. In opening the debate, the Secretary of State described it as the "final building block" in a national health service that will survive while the Prime Minister lives and breathes.
The Bill is not an impressive conclusion or summation of Mrs. Thatcher's vision when first embarking on the project. What started—indeed, what swept in—in the mid-1980s like Boadicea's chariot, and caused almost as much chaos, is ending in farce and confusion, as if Boadicea had been replaced by Mr. Bean. Heralded as a streamlining measure, it attracts bureaucracy and leaves unanswered more questions than it deals with.
Perhaps I may put this question to the Minister: if the Bill is supposed to save money, why is it followed by a money resolution? I suppose that the Minister will answer that it will save money later but may require expenditure of funds immediately. It certainly looks that way.
There is, and always was, a case for merging district health authorities and family health services authorities in England and Wales, but it follows logically that the opportunity should have been taken to provide the national health service with coherent boundaries at local level, to parallel the well understood community boundaries used by local government. There is no case for a separate, geographically incoherent map solely for the national health service, which continues to be disfigured by demarcation disputes with local authorities about community care provision. The Bill could have dealt with that structural issue, but it did not, and the present situation will be allowed to continue. Whatever else the Bill may be, it cannot be described as the completed reform agenda of which the Government boast.
The Government's second and more controversial structural reform is to convert the eight remaining regional health authorities in England to eight regional outposts of the NHS executive. The claim for that agenda is that it will abolish a layer of bureaucracy. As my hon. Friend the Member for Morley and Leeds, South (Mr. Gunnell) and others correctly pointed out, the Bill dloes nothing of the sort; it merely transfers the regional tier from the national health service to the civil service. 'The new structure makes the regional tier directly responsible to the Secretary of State.
As civil servants, staff will be subject to the terms of the Official Secrets Act 1911 and their first duty will be not to the NHS or to patients but to care for the Secretary of State in the community. It is perfectly possible—

Mr. Jenkin: rose—

Mr. Brown: I would have given way, but I am beginning to share the Prime Minister's opinion of the hon. Gentleman, who did not give way to me, so I will not give way now.
It is perfectly possible that the agenda will increase rather than decrease the number of administrators needed. With the new joint arrangements between the different health authorities, it is quite possible that we shall put in place a new tier of administration, and do so in an ad hoc manner.
In any event, the changes must be set in the context of the rest of the Government's health care reforms. Before doing that, I should refer to the first-rate speech by my hon. Friend the Member for York (Mr. Bayley), who spoke of the injustices of the Government's current method of allocating resources, with specific reference to the absolute nonsense of merging the Yorkshire and Northern regions.
The Northern region alone is the size of Wales, and the entire new region of Yorkshire and the North is the same size as Scotland; yet we are told that the resources


allocated to its regional office will be broadly similar to those allocated to smaller regions. It is difficult to conclude that that is anything other than a political decision. The Government are advantaging areas where there are Conservative seats at the expense of areas where there are predominantly Labour seats.
The broader context is well known, but it will not hurt to remind the House of it. Since 1988, the number of NHS managers has increased by an astonishing 1,538.3 per cent. In 1993 alone, the number of managers employed by the NHS increased by 13.5 per cent.—this from a Government who claim to be committed to cutting bureaucracy. Since 1987, total costs throughout the NHS have risen from £1.44 billion to £3.02 billion, with an increase of 110 per cent. in administration costs alone.
The proportion of the total NHS budget spent on administration, clerical and management costs rose from 8.77 per cent. in 1987£1988 to 10.8 per cent. in 1992£1993. It used to be a source of pride that administrative costs in the NHS were lower than elsewhere in the developed world, but the Government have thrown that advantage away with their new structure without demonstrating the corresponding benefits from the new system.
We shall want to examine in more detail in Committee the allocation of responsibilities and functions between the health authorities and regional offices, but a number of important questions ought to be raised now. Who will hold the contracts of junior doctors? Who will maintain and monitor cancer screening services? That question was put directly to the Secretary of State, who responded by praising the services. I join her wholeheartedly in so doing—that is not an issue of contention between the parties—but she did not say who will maintain and monitor the cancer screening services.
Who will be responsible for the vocational training of general practitioners? What provision has been made for a national overview of nurses' training? How will day-to-day responsibility for GP fundholders be managed, given that that responsibility is now passing directly to the Secretary of State even though the resources are to come from the local health authorities? It is a bit much for the Secretary of State to say that an incoming Labour Government would be centralising and totalitarian—she refers to us as Stalinist—when she is centralising significant powers theoretically in her own hands. When she said that a Labour Government would have authoritarian powers, she was perhaps referring to the structures that she will hand over to the incoming Labour Government.
The training of nurses is an important matter. Training is being devolved, as I understand it—I am willing to be corrected if I am wrong—to local consortia of NHS trusts. As I have said, those consortia—they have yet to come into being—could create a whole new tier of administration. The structure is bound to make the planning of nurses' training more problematic, and it may result increasingly in shortages of trained nursing staff.
The failure to address obvious long-term planning issues has been accompanied by a failure to invest in nursing training and the long-term future of the NHS. The Secretary of State seemed to recognise that problem, because, in what I took to be an effective adjustment of the contents of the Bill, she said that regional directors

would be invited to take a special interest in that matter. That suggests that the case for a regional tier is almost being rebuilt as the details of the Bill are examined by the House.
My hon. Friend the Member for Nottingham, East (Mr. Heppell) rightly pointed out that public confidence in the proposed arrangements has been further undermined by the lack of any democratic accountability. The public interest will be represented on those new structures by the usual Conservative business men or close relatives or friends of Conservative Members. The public find that quangosity wholly unconvincing and they are fed up with it.
A legitimate debate may be held about exactly where and how the lay interest of health service consumers should be represented in the NHS. I do not believe that there is any one absolutely correct method of representing local public interest, but it should surely be represented by people chosen by the public and it should specifically not be undertaken by those whom the Secretary of State has chosen—especially since they all seem to be drawn from the ranks of the supporters of the right hon. Lady's party and their relatives. [Interruption.] I am happy to give way to the right hon. Lady, who is muttering; perhaps she has thought of someone whom the public would accept.

Mrs. Virginia Bottomley: I am surprised that the hon. Gentleman has no recollection of Helene Hayman, among many others.

Mr. Brown: The Secretary of State offers me one name that she has managed to find from the great list of placemen—one person who she considers I might think reputable. I accept that one name, but we are looking for more than that.

Mrs. Bottomley: If the hon. Gentleman would like a great list of names, I would be prepared to discuss them with him. He should bear in mind, however, that a great many people in the Labour party are becoming progressively more embarrassed by the need to identify them. They wish that the Opposition would turn round and say that they support trusts and the progress made in health authorities and stopped putting the frighteners on their own people.

Mr. Brown: We do not support trusts, but it is permissible for members of our party to be members of them.

Mr. Mans: That is not true.

Mr. Brown: We have always made it perfectly clear that we do not support the trusts that the Secretary of State has established, but we want to participate in the democratic mechanisms of the NHS. A statement—now several years old—from the national executive of the Labour party authorised members of the party to become members of a trust if invited to do so. It is a lie spread by Conservative Members that members of my party would be under some disciplinary injunction if they participated in the work of a trust. That is wrong and untrue.
I suspect that the reason why there are not more Labour party members on trusts is that they are not chosen by the Secretary of State and those who advise her. In fairness to the chairman of the Conservative party, he made it


perfectly clear that he wants to choose people who support the Conservative party to work on trusts and not supporters of its political opponents.
I took what the Secretary of State said to be an invitation for more Labour names to be proposed to try to give some respectability to institutions of whose very structures the Labour party is deeply critical. It would be easier to put such names forward were it not for the fact that the exact composition of health authority boards is unclear. It is astounding that we are having this debate when we do not know from precisely which areas those who are to serve on the new committees will be drawn.
We understand that the chairs will be appointed by the Secretary of State. As my hon. Friends have already said, in practice that will undoubtedly mean that those people will be political appointees of the Conservative party. The Secretary of State implies that I might be surprised. I am ready to be surprised, but I do not think that I shall be. The remaining five executive members and the five non-executive members will be left for the regulations to determine.
I have to say to the Minister for Health, who is presumably to steer the Bill through Committee, that we shall expect to have the details before the Bill leaves Committee. The Secretary of State has said that there will be a role for senior figures from the world of public health, that there will be a role for the medical dean or equivalent figure from the world of dentistry, and that for the other posts she will seek in her appointments—for they are indeed her appointments—people with health backgrounds, a full range of health professionals. What that will mean in practice remains to be spelt out in regulations; it is not obvious from the structure of the Bill. The House is entitled to a full explanation of what it is expected to be legislating for before we legislate, not afterwards.
The abolition of the regional health authorities removes the statutory position of universities and medical schools under the National Health Service and Community Care Act 1990. As I am sure the Minister recalls, that enables them to participate in regional planning and decision making. It is not obvious what arrangements will now be in place for their participation in strategic decision making, and the Bill does not guarantee a role for health care user groups in the decision-making process of health authorities.
As the Secretary of State contended in her introduction to the debate, one way of proving that everyone is content with everything is not to provide i unified system for processing complaints. My hon. Friend the Member for Cannock and Burntwood (Dr. Wright) referred to the work of Professor Alan Wilson, vice-chancellor of the university of Leeds, who chaired a committee to consider that subject and made some important recommendations, which the Secretary of State appears to have ignored. He recommended a single system, with similar features, for handling all complaints about NHS care and services. I took careful note of the Minister's intervention to my hon. Friend, but an intervention promising action in future is not the same as tackling the issue where it should be tackled: in a Bill that is intended to be the final building block in the Government's health care reform, although according to the Minister some cement is still to come—we shall see.
I should be happier if we were able to discuss Professor Wilson's recommendations in Committee. He recommended that the complaints procedure should be separate from the disciplinary systems. He recommended a three-level complaints procedure, including an independent panel chaired by a lay person and with a lay majority; he did not say anything about the Secretary of State appointing them all. He also made recommendations to widen the role of the Health Service Commissioner—another subject on which the Secretary of State has been silent. The Bill is intended to complete the Government's health reform agenda; yet the subject of complaints is not tackled.
Although the Bill sets out to draw several new boundaries, the one boundary that has been overlooked appears to be the most glaring omission—the case for a strategic authority for London. Health care in London has a range of problems; yet they are all tackled in an episodic and piecemeal way. There is no London wide health authority or health care strategy and no London wide review of the condition of accident and emergency services. There is chronic underfunding of London health care. High levels of special need, caused by social deprivation in London, remain unmet. Indeed, there is a specific threat to units such as the North Thames region ethnic minorities unit because the passage of the Bill may leave no one to finance it.
It is right to consider the other serious problems caused by earlier Government health care reforms which remain unsolved by the Bill: massive hospital in-patient waiting lists; a two-tier system of health care, of which the Conservatives are so proud, with GP fundholders able to fast-track their patients; hospital trusts which act like independent businesses and are almost impossible to call to account; and competition between hospitals resulting from the internal market and leading to inefficient duplication in some sectors and neglect of others.
Local variations in service provision seem to many to be politically driven. There are continuing bed and ward closure programmes. In 1993 alone, the service lost 10,637 beds. There has been a relentless encroachment on public services by private medical interests and an astonishing growth in maladministration and even corruption, as identified by the recent reports of the Public Accounts Committee. Now there is an absurd, expensive and inefficient row about performance-related pay and local rather than national pay bargaining.
We are told that all of this is the final, triumphant conclusion to the Government's health care reform agenda and the Government confidently ask the British people to judge them on the result. On that, we can all agree: I, too, hope that the British people will judge the present Government on what they have done to the national health service.

The Minister for Health (Mr. Gerald Malone): We have now heard from the hon. Member for Newcastle upon Tyne, East (Mr. Brown) that he and his party are against trusts. That is not quite what the right hon. Member for Derby, South (Mrs. Beckett) said earlier. I am pleased that we have at last managed to get the admission from them.

Mrs. Beckett: This is deeply boring as well as extremely stupid. The Minister and his colleagues have


repeatedly been told by the Opposition that we are of course against the existence of national health service trusts. Had we come to power in 1992, we would have got rid of them. There are so many of them that all the individual hospitals are likely to be trusts. We are looking for a new way to re-knit individual health businesses into a co-ordinated structure. The fact that we are against health service trusts has never been in doubt, and it never will be, because they are destroying the national health service.

Mr. Malone: The right hon. Lady has now adopted an even more interesting position—I hope that she has cleared it with her shadow Cabinet colleagues. She is against trusts which are destroying the health service, but her party is going to do nothing about it as there are too many of them and they have succeeded—that is an extraordinary position. In fact, the pass was sold by the hon. Member for Wakefield (Mr. Hinchliffe) at the beginning of the debate when he helpfully said, from a sedentary position, that he and his party were the first ones to think of the reforms contained in the Bill, which were an extremely good idea.

Mr. Hinchliffe: rose—

Mr. Malone: I shall be delighted to give way to the hon. Gentleman so that he can expand on his position at greater length.

Mr. Hinchliffe: I do not think that the Minister was around in 1989 when what became the National Health Service and Community Care Act 1990 was going through Standing Committee. The Secretary of State was, and she will recall that the Labour position was that we would bring together the district health authorities and the family health services authorities, which is now the Government's position. Why have the Government taken so long to come round to Labour's policies?

Mr. Malone: As the hon. Gentleman said, I was temporarily displaced at that time, but I continued to take a great interest in the affairs of the House. I am delighted that the hon. Gentleman has intervened in the debate and confirmed that he thinks that the Bill's principles are sensible. I am sure that that view is shared by his Front-Bench colleagues and by others.
The right hon. Member for Derby, South did not know whether she was coming or going when she opened the debate. At one moment she argued 'that the Bill would ensure that the service was fragmented, split up and spread around the country so that there was, ultimately, no NHS, which would be the end of life as we know it. We then heard her say that she objected to the Bill because it would centralise everything. According to her, it is a centralising Bill and a fragmenting Bill at the same time, as well as being a privatising Bill. I am not sure which of the strands she intended to follow, but her arguments were entirely contradictory.
What the Bill does, and what my right hon. Friend the Secretary of State set out to say that it does, is to put the final touches to a structure that is now firmly in place. It is a logical and reasonable Bill to conclude that process and is widely accepted by the country. At heart, the point of it is recognised by Opposition Members who,

throughout the debate, have argued and given their views on the health service, but have not done much to criticise the essence of the Bill.
The right hon. Member for Derby, South said that the executive was being floated off by the Secretary of State. Nothing could be further from the truth. The NHS executive is part of the organisation, accountable to Ministers just like the rest of the Department of Health, and it will remain so. It is informed by internal market guidance, just as the whole service will be. There are clear and practical ground rules for judging the balance between local purchasers and national responsibilities. Local freedoms and responsibilities must be kept in balance, and there is a simple set of principles further to improve the efficiency and quality of responsiveness of the service to the needs of patients. That is what the internal market guidance is for, and it largely answers the points raised by the right hon. Lady.
The right hon. Lady also made the point that consultation on trusts would no longer be compulsory. I assure the House that there is no intention of abolishing consultation, which will be carried out by the Secretary of State or by the trusts themselves. It makes sense to cover the range of possible circumstances when consultation will be needed in regulations, so that we may adjust as necessary. That is better than rigid provisions that would entail primary legislation when circumstances changed. It is surely right to build in such flexibility.
The right hon. Lady also discussed the abolition of professional advisory committees. Frankly, I do not believe that they were much loved. They were widely criticised and were ineffective. We shall be looking to health authorities to demonstrate that professional input is far more integrated in their work—input not just by the professions but across the professions. The integration of such advice is important; there are many models in the best health authorities of nurses and doctors either in executive posts or being consulted in other ways. They participate in constructive discussions between clinicians, purchasers and trusts, and the help of outside experts is also called upon. This puts the consultation process well beyond the formality that it sometimes became. It was often ignored and left on the sidelines: we are giving it real life.
The right hon. Member for Derby, South also mentioned the independence of public health officials. District public health officers will report on the health of their local populations and will be free to comment on it. The regional role will become different under the new structure. It will be to carry out functions on behalf of the executive. No longer will there be a regional report on the health of a region's population. The experience of the whole service has been that, as care has devolved ever closer to the patient, it has become more important to identify local need. That is why public health functions, when devolved to district level, will be more effective at identifying trends and putting in place policies to deal with them.
A couple of ancillary, and sedentary, points were raised at the start of the debate in connection with the Northern and Yorkshire regional office site appraisal. Of course the Public Accounts Committee can call for full documentation. Some Members of Parliament, including one who raised the issue, have already asked for, and received, a summary of what has been proposed. The only details left out are estimates of prices, which must be left


out as the district health authorities still hope to obtain better prices than have thus far been submitted. The whole process has been effected according to Treasury rules. There is nothing to hide; indeed, I am surprised that hon. Members brought up the subject at all.
My hon. Friend the Member for Hereford (Mr. Shepherd) made a powerful constituency speech. I can reassure him that we have no preconceptions about the size of the authorities, about the organisation of the services that they will provide, or about whether local authority boundaries should coincide. I assure my hon. Friend that there will be consultation as the process continues, when provisional recommendations are drawn up by the regions. His powerful points of today will certainly be borne in mind. We adopted the same approach to the new regional health authorities, but that did not stop us changing boundaries in response to compelling local representations.
My hon. Friend also made a couple of points about the provision of services. Of course the Secretary of State has a duty, clearly set out in primary legislation, to provide the whole population in England with a comprehensive health service. I hope that he will understand that, when authorities of whatever sort are shaping their services, they will have to bear that in mind.
The hon. Member for Nottingham, East (Mr. Heppell) spoke about joint executives of district health authorities and family health services authorities. He underpinned the fact that those authorities are beginning to coalesce naturally and sensibly. I hope that he welcomes that. It has happened in my constituency and it has been very effective. The legislation recognises the coming together of structures.

Mr. Heppell: rose—

Mr. Malone: I hope that the hon. Gentleman will forgive me if I do not give way. I listened to his speech and I wish to answer some of the other points that were raised in the debate.
My hon. Friend the Member for Colchester, North (Mr. Jenkin) was courteous enough to tell me that he could not be in his place for my winding-up speech because he has a constituency engagement. He spoke about weighted capitation, as did other hon. Members. Work is in hand to develop a new approach to resource allocation. It is a complex issue which needs a great deal of careful thought, but the Government remain committed to allocation by a formula which will demonstrate a clear need to devolve spending according to local need. That demonstrates our clear commitment to the principle of access to health care within and between regions in a properly informed way.
My hon. Friend the Member for Colchester, North also spoke about health authorities competing with general practice fundholders. They are in partnership, not competition. The GP fundholding accountability framework, which has been published for consultation, should help to clarify that relationship in the best possible way. I hope that my hon. Friend understands that.
The hon. Member for York (Mr. Bayley) spoke at length about inequalities and resource allocation. I wholly refute his allegation that the north has been treated unfairly in resource allocations for 1995–96. Allocations to regional health authorities are not the real issue. The real issue is the allocation to district health authorities. Regional health authorities will take into account the

directions in the new calculations when they make next year's allocations to DHAs. There is no sense in making major changes to regional health authority allocations for the final year when there is only one year to run.
Regional health authorities can be expected to manage changes to the DHA allocations at a sensible pace. I was glad to hear the hon. Gentleman acknowledge that it would be pointless if it caused substantial dislocation. As we move towards a new formula and its total implementation, we must move evenly so that dislocations do not occur.

Mr. Bayley: rose—

Mr. Malone: I apologise to the hon. Gentleman. I said earlier that I did not intend to give way and my usual bonhomie in giving way must not be demonstrated now, as there are many matters to which I must respond.
The hon. and learned Member for Montgomery (Mr. Carlile) spoke about the public health function and the future of services. His fear that public health doctors will be gagged is entirely unfounded. Health authorities will be required to have medical directors of public health and to publish annual reports. That, not the regional level, is the right level for such reports. They will be crucial in determining the future of local services, and it will be for health authorities to decide which services are needed locally and which will be needed in specialist units.
The hon. and learned Gentleman asked what voices would be heard on the new authorities. I reiterate what my right hon. Friend the Secretary of State said in her speech—that it is important that the boards comprise the best people locally to provide the balance of skills that are needed. We expect that a growing number of members in executive or non-executive positions will have backgrounds in nursing or medicine or in other professions. That is a growing trend throughout the health service and I welcome it.
The hon. and learned Gentleman asked about consultation with community health councils. He will be glad to know that there will be no change in the requirement on health authorities to consult CHCs, nor is there is any intention of changing their number. He spoke about the local accountability of health authorities. I entirely agree that new health authorities should be clearly accountable to local populations. That can be done in a number of ways—for example, by establishing a single local body. The Bill simplifies local accountability arrangements, and that means that, demonstrably, the public will be able to know who is providing the service and who is purchasing it on their behalf and they will have a far clearer input to it. Health authorities will continue to be required to transact all important business in public, to publish accounts, reports and strategic plans and to consult widely on all key proposals.
The hon. and learned Gentleman's final point was about the supervision of midwifery. The responsibly for that will shift from regional health authorities to the new health authorities. That is as the hon. and learned Gentleman wishes it to be, so I hope that he is reassured.
The hon. Member for Morley and Leeds, South (Mr. Gunnell) asked why the Northern and Yorkshire regional office is to be located in Durham. The decision on relocation follows an extensive appraisal of a wide range of options. My right hon. Friend the Secretary of State has authorised the regional health authority to pursue locations in Durham, subject to a strict cost calculation.
The hon. Gentleman also raised a point about policy board members not being representative of regions. We are not suggesting that they should formally represent regions. The argument goes to the core of what Labour Members think—that throughout the health service people should be representatives of sectional interests. That is not the way that we see it. We want them to represent the interests of the service and of the patients. We want them to be drawn from the widest possible constituency.
The hon. Member for Cannock and Burntwood (Dr. Wright) made an interesting speech, with which I obviously agreed at exactly the right moment because he then went on to disagree with everything that the Government are doing. He said that the Bill centralises too much, but he was one of the centralisers. He also said that the Bill gives too many regulation-making powers to the Secretary of State.
I find it difficult to recognise the Bill that the hon. Gentleman described. It is always sensible to put in regulations the detailed provisions that may need to be adjusted from time to time. The majority of the enabling powers in the Bill already exist in relation to district health authorities—for example, provisions on membership and on joint working between authorities. There are already matters for secondary legislation. The hon. Gentleman may think that it would be far better to have a 700-clause Bill on these issues, but I do not. The future of the NHS is much better served by a flexible structural framework.

Mr. Nicholas Brown: I understand what the Minister means when he says that some matters are better dealt with in regulations than in primary legislation, and on that point of principle there is no quarrel. However, on some of the key issues, we want to see what will be in the regulations before we let the Bill come out of Committee.

Mr. Malone: The hon. Gentleman makes a Committee point, which he and I can explore some time in the new year. My point is sensible and straightforward. The issues that will be subject to regulation are no different from those that have been subject to regulation in the past. Throughout the debate, the Opposition have suggested that something novel is involved— [Interruption.] If the hon. Member for Cardiff, West (Mr. Morgan) would remain silent for a second, his hon. Friend the Member for Newcastle upon Tyne, East might hear what I am saying. There is nothing novel, in dealing with arrangements by regulation. Of course the Committee will explore the Government's intentions. I shall be glad to do so.
The hon. Member for Cannock and Burntwood asked about the remaining statutory right for community health councils to be consulted. I have dealt with that point, but I repeat that we remain committed to consultation. They will be among the bodies specified in the regulations to be consulted on the establishment of new trusts.
The hon. Gentleman also said that membership should be specified in the Bill. As I said, it would not be sensible to do that. It is far better to have wide powers and the ability to seek talent where we can and in the widest possible way than to follow the representative route wanted by Labour Members.
My hon. Friend the Member for Windsor and Maidenhead (Mr. Trend) made a constituency speech and raised a specific point about the Edward VII hospital. He asked what we could do about appropriate accommodation for the elderly. Suitable accommodation for elderly people is already available within a reasonable distance of the hospital. I have heard what he said and hope that he will take the opportunity either to write to me on that issue or to come and meet me, when I shall be happy to discuss the matter with him further.
The Bill is the last building block of the reforms that we introduced in 1990. I am sorry that, yet again during the debate, we have heard from Opposition Members, including the right hon. Member for Derby, South, appalling slurs against all those who serve on trust boards and health authority boards, in terms of their selection and interest. I challenge the right hon. Lady to give a single instance of misconduct. If Opposition Members have evidence that they have acted against the interests of the trust boards on which they serve, I invite them, with the protection of the House, to give a few instances instead of those vague slurs against people who give voluntary service in the best tradition of British public life.

Mrs. Beckett: I am not sure which debate the Minister attended, but as I said nothing about members of trust boards, I do not know what he is talking about.

Mr. Malone: The right hon. Lady and her hon. Friends forever talk about Tory placemen on boards. Nothing of the sort exists. If one wishes to discuss the position of people on authorities, one need look no further than the Labour party to see what instructions are given. I was fascinated by an Opposition Member's Freudian slip when he said that, at some point, the Labour party had "authorised" its members to serve on those boards. They get the authority from Walworth road, but it goes beyond simple authority. Not only is their appointment to boards authorised but they are given instructions. I quote from the "Guidance on participation" issued by the Labour party's national executive committee.

Mr. Nicholas Brown: Will the Minister give way?

Mr. Malone: No. I shall give way to the hon. Gentleman once I have read out the instructions issued by his party.
The "Guidance on participation" says:
Labour party members may take up places on non-elected authorities and use them as a platform for our campaigning".
Labour Members are not in the least interested in serving the board—they are interested only in serving their party. That is not all. The guidance goes on:
Party members who are appointed to non-elected boards must discuss ways of reporting back to their local constituencies and other constituencies … Consideration should be given to ways of liaising with Labour Party representatives in other capacities ….Members accepting appointments of this kind should inform Walworth Road so that the relevant Shadow spokespeople and Head Office policy officers can maintain a network of contacts".
The instructions given by the Labour party to its representatives on boards are more detailed than those the KGB ever gave Richard Gott of The Guardian. I do not know how they are delivered—whether it is by dead letter boxes in Islington or tete-a-tetes in the Gay Hussar—but instructions are clearly given to make it absolutely certain that Labour members turn to party interests when they are meant to be serving on boards in the public interest.
The Bill puts in place important reforms at the end of a series of reforms that now deliver better health care at a better cost than ever before. The health service is now recognised for its excellence not only in this country but abroad. Opposition Members should look at the OECD report and British attitude surveys that are now being published on the excellence which people now consider the health service delivers. As I asked the right hon. Member for Derby, South to do, I ask them to look at the figures on this matter. They should look at the number of operations, the treatment that is given and the services which the NHS can deliver in primary health care, which it was unable to deliver before.
That improvement across a system that is delivering better health care, better value for the taxpayer and increased volume of health care is something of which we can be proud. The Opposition have not made their case against the Bill. They tabled a token reasoned amendment but did not speak to it. I have every confidence in supporting the Bill before the House tonight, and I invite my right hon. and hon. Friends and Opposition Members who support the reforms to join me in the Lobby.

Question put, That the amendment be made:—
The House divided: Ayes 267, Noes 308.

Division No. 18]
[22.00 pm


AYES


Abbott, Ms Diane
Chisholm, Malcolm


Adams, Mrs Irene
Church, Judith


Ainger, Nick
Clapham, Michael


Ainsworth, Robert (Cov'try NE)
Clark, Dr David (South Shields)


Allen, Graham
Clarke, Eric (Midlothian)


Alton, David
Clarke, Tom (Monklands W)


Anderson, Donald (Swansea E)
Clelland, David


Anderson, Ms Janet (Ros'dale)
Clwyd, Mrs Ann


Armstrong, Hilary
Coffey, Ann


Ashdown, Rt Hon Paddy
Cohen, Harry


Ashton, Joe
Connarty, Michael


Austin-Walker, John
Cook, Frank (Stockton N)


Banks, Tony (Newham NW)
Cook, Robin (Livingston)


Barnes, Harry
Corbett. Robin


Barron, Kevin
Corbyn, Jeremy


Battle, John
Corston, Jean


Bayley, Hugh
Cousins, Jim


Beckett. Rt Hon Margaret
Cox, Tom


Beith, Rt Hon A J
Cummings, John


Benn, Rt Hon Tony
Cunliffe, Lawrence


Bennett, Andrew F
Cunningham, Jim (Covy SE)


Benton, Joe
Cunningham, Rt Hon Dr John


Bermingham, Gerald
Dalyell, Tam


Berry, Roger
Darling, Alistair


Betts, Clive
Davidson, Ian


Blunkett, David
Davies, Bryan (Oldham C'tral)


Boateng, Paul
Davies, Ron (Caerphilly)


Boyes, Roland
Davies, Rt Hon Denzil (Llanelli)


Bradley, Keith
Davis, Terry (B'ham, H'dge H'I)


Bray, Dr Jeremy
Denham, John


Brown, Gordon (Dunfermline E)
Dewar, Donald


Brown, N (N'c'tle upon Tyne E)
Dixon, Don


Bruce, Malcolm (Gordon)
Dobson, Frank


Burden, Richard
Donohoe, Brian H


Caborn, Richard
Dowd, Jim


Callaghan, Jim
Dunnachie, Jimmy


Campbell, Menzies (Fife NE)
Dunwoody, Mrs Gwyneth


Campbell, Mrs Anne (C'bridge)
Eagle, Ms Angela


Campbell, Ronnie (Blyth V)
Eastham, Ken


Campbell-Savours, D N
Enright, Derek


Canavan, Dennis
Etherington, Bill


Cann, Jamie
Evans, John (St Helens N)


Carlile, Alexander (Montgomry)
Fatchett, Derek


Chidgey, David
Field, Frank (Birkenhead)





Fisher, Mark
Mandelson, Peter


Flynn, Paul
Marek, Dr John


Foster, Don (Bath)
Marshall, David (Shettleston)


Foster, Rt Hon Derek
Martin, Michael J (Springburn)


Foulkes, George
Martlew, Eric


Fraser, John
Maxton, John


Fyfe, Maria
McAllion, John


Galloway, George
McAvoy, Thomas


Gapes, Mike
McCartney, Ian


Garret, John
McFall, John


George, Bruce
McKelvey, William


Gerrard, Neil
McLeish, Henry


Gilbert, Hon Dr John
McMaster, Gordon


Godsiff, Roger
McNamara, Kevin


Golding, Mrs Llin
McWilliam, John


Gordon, Mildred
Meacher, Michael


Grant, Bernie (Tottenham)
Meale, Alan


Griffiths, Nigel (Edinburgh S)
Michael, Alun


Griffiths, Win (Bridgend)
Michie, Bill (Sheffield Heeley)


Grocott, Bruce
Michie, Mrs Ray (Argyll  Bute)


Gunnell, John
Milburn, Alan


Hain, Peter
Miller, Andrew


Hall, Mike
Mitchell, Austin (Gt Grimsby)


Hanson, David
Moonie, Dr Lewis


Harman, Ms Harriet
Morgan, Rhodri


Harvey, Nick
Morley, Elliot


Hattersley, Rt Hon Roy
Morris, Estelle (B'ham Yardley)


Henderson, Doug
Morris, Rt Hon Alfred (Wy'nshawe)


Heppell, John
Mowlam, Marjorie


Hill, Keith (Streatham)
Mudie, George


Hinchliffe, David
Mullin, Chris


Hodge, Margaret
O'Brien, Bill (Normanton)


Hoey, Kate
O'Brien, Mike (N W'kshire)


Hogg, Norman (Cumbernauld)
O'Hara, Edward


Home Robertson, John
O'Neill, Martin


Howarth, George (Knowsley N)
Oakes, Rt Hon Gordon


Howells, Dr. Kim (Pontypridd)
Olner, Bill


Hoyle, Doug
Orme, Rt Hon Stanley


Hughes, Kevin (Doncaster N)
Parry, Robert


Hughes, Robert (Aberdeen N)
Pendry, Tom


Hughes, Roy (Newport E)
Pickthall, Colin


Hughes, Simon (Southmark)
Pike, Peter L


Hutton, John
Pope, Greg


Illsley, Eric
Powell, Ray (Ogmore)


Jackson, Glenda (H'stead)
Prentice, Bridget (Lew'm E)


Jackson, Helen (Shef'ld, H)
Prentice, Gordon (Pendle)


Jamieson, David
Prescott, Rt Hon John


Janner, Greville
Primarolo, Dawn


Jones, Barry (Alyn and D'side)
Purchase, Ken


Jones, Ieuan Wyn (Ynys Mon)
Quin, Ms Joyce


Jones, Jon Owen (Cardiff C)
Radice, Giles


Jones, Lynne (B'ham S O)
Randall, Stuart


Jones, Martyn (Clwyd, SW)
Raynsford, Nick


Jones, Nigel (Cheltenham)
Reid, Dr John


Jowell, Tessa
Rendel, David


Kaufman, Rt Hon Gerald
Robertson, George (Hamilton)


Keen, Alan
Roche, Mrs Barbara


Kennedy, Charles (Ross,CS)
Rogers, Alan


Kennedy, Jane (Lpool Brdgn)
Ross, Ernie (Dundee W)


Khabra, Piara S
Rowlands, Ted


Kilfoyle, Peter
Ruddock, Joan


Kinnock, Rt Hon Neil (Islwyn)
Sheerman, Barry


Kirkwood, Archy
Sheldon, Rt Hon Robert


Lestor, Joan (Eccles)
Shore, Rt Hon Peter


Lewis, Terry
Short, Clare


Liddell, Mrs Helen
Simpson, Alan


Litherland, Robert
Skinner, Dennis


Livingstone, Ken
Smith, Andrew (Oxford E)


Llwyd, Elfyn
Smith, Chris (Isl'ton S  F'sbury)


Loyden, Eddie
Smith, Dew (Blaenau Gwent)


Macdonald, Calum
Soley, Clive


Mackinlay, Andrew
Spearing, Nigel


MacShane, Denis
Spellar, John


Madden, Max
Squire, Rachel (Dunfermline W)


Maddock, Diana
Steel, Rt Hon Sir David


Mahon, Alice
Steinberg, Gerry






Stevenson, George
Wareing, Robert N


Stott, Roger
Watson, Mike


Strang, Dr. Gavin
Wicks, Malcolm


Straw, Jack
Wigley, Dafydd


Sutcliffe, Gerry
Williams, Alan W (Carmarthen)


Taylor, Matthew (Truro)
Williams, Rt Hon Alan (Sw'n W)


Taylor, Mrs Ann (Dewsbury)
Wilson, Brian


Thompson, Jack (Wansbeck)
Winnick, David


Timms, Stephen
Wray, Jimmy


Tipping, Paddy
Wright, Dr Tony


Turner, Dennis
Young, David (Bolton SE)


Vaz, Keith



Walker, Rt Hon Sir Harold
Teller for the Ayes:


Walley, Joan
Mr. Stephen Byers and


Wardell, Gareth (Gower)
Mr. Geoffrey Hoon.


NOES


Ainsworth, Peter (East Surrey)
Congdon, David


Aitken, Rt Hon Jonathan
Conway, Derek


Alexander, Richard
Coombs, Simon (Swindon)


Alison, Rt Hon Michael (Selby)
Cope, Rt Hon Sir John


Allason, Rupert (Torbay)
Cormack, Patrick


Amess, David
Couchman, James


Arbuthnot, James
Cran, James


Arnold, Jacques (Gravesham)
Currie, Mrs Edwina (S D'by'ire)


Arnold, Sir Thomas (Hazel Grv)
Davies, Quentin (Stamford)


Ashby, David
Day, Stephen


Aspinwall, Jack
Deva, Nirj Joseph


Atkins, Robert
Devlin, Tim


Atkinson, David (Bour'mouth E)
Dicks, Terry


Atkinson, Peter (Hexham)
Dorrell, Rt Hon Stephen


Baker, Nicholas (Dorset North)
Douglas-Hamilton, Lord James


Baker, Rt Hon K (Mole Valley)
Dover, Den


Baldry, Tony
Duncan Smith, Iain


Banks, Matthew (Southport)
Duncan, Alan


Banks, Robert (Harrogate)
Dunn, Bob


Bates, Michael
Durant, Sir Anthony


Batiste, Spencer
Dykes, Hugh


Bellingham, Henry
Eggar, Tim


Bendall, Vivian
Emery, Rt Hon Sir Peter


Beresford, Sir Paul
Evans, David (Welwyn Hatfield)


Biffen, Rt Hon John
Evans, Jonathan (Brecon)


Bonsor, Sir Nicholas
Evans, Nigel (Ribble Valley)


Booth, Hartley
Evans, Roger (Monmouth)


Boswell, Tim
Evennett, David


Bottomley, Peter (Eltham)
Faber, David


Bottomley, Rt Hon Virgina
Fabricant, Michael


Bowden, Sir Andrew
Fenner, Dame Peggy


Bowis, John
Field, Barry (Isle of Wight)


Boyson, Rt Hon Sir Rhodes
Fishburn, Dudley


Brandreth, Gyles
Forman, Nigel


Brazier, Julian
Forsyth, Michael (Stirling)


Bright, Sir Graham
Forth, Eric


Brooke, Rt Hon Peter
Fowler, Rt Hon Sir Norman


Brown, M (Brigg  Cl'thorpes)
Fox, Dr Liam (Woodspring)


Browning, Mrs. Angela
Fox, Sir Marcus (Shipley)


Bruce, Ian (Dorset)
Freeman, Rt Hon Roger


Budgen, Nicholas
French, Douglas


Burns, Simon
Fry, Sir Peter


Burt, Alistair
Gale, Roger


Butcher, John
Gallie, Phil


Butler, Peter
Gardiner, Sir George


Butterfill, John
Garel-Jones, Rt Hon Tristan


Carlisle, John (Luton North)
Garnier, Edward


Carlisle, Sir Kenneth (Lincoln)
Gill, Christopher


Carrington, Matthew
Gillan, Cheryl


Cash, William
Goodson-Wickes, Dr Charles


Channon, Rt Hon Paul
Gorman, Mrs Teresa


Churchill, Mr
Gorst, Sir John


Clappison, James
Grant, Sir A (Cambs SW)


Clark, Dr Michael (Rochford)
Greenway, Harry (Ealing N)


Clarke, Rt Hon Kenneth (Ru'clif)
Greenway, John (Ryedale)


Clifton-Brown, Geoffrey
Griffiths, Peter (Portsmouth, N)


Coe, Sebastian
Grylls, Sir Michael


Colvin, Michael
Gummer, Rt Hon John Selwyn





Hague, William
McLoughlin, Patrick


Hamilton, Neil (Tatton)
McNair-Wilson, Sir Patrick


Hamilton, Rt Hon Sir Archibeld
Mellor, Rt Hon David


Hampson, Dr Keith
Merchant, Piers


Hanley, Rt Hon Jeremy
Mills, Iain


Hannam, Sir John
Mitchell, Andrew (Gedling)


Hargreaves, Andrew
Mitchell, Sir David (Hants NW)


Harris, David
Moate, Sir Roger


Haselhurst, Alan
Molyneaux, Rt Hon James


Hawkins, Nick
Montgomery, Sir Fergus


Hawksley, Warren
Needham, Rt Hon Richard


Hayes, Jerry
Nelson, Anthony


Heald, Oliver
Neubert, Sir Michael


Heathcoat-Amory, David
Newton, Rt Hon Tony


Hendry, Charles
Nicholson, David (Taunton)


Heseltine, Rt Hon Michael
Nicholson, Emma (Devon West)


Hicks, Robert
Norris, Steve


Higgins, Rt Hon Sir Terence
Onslow, Rt Hon Sir Cranley


Hill, James (Southampton Test)
Oppenheim, Phillip


Hogg, Rt Hon Douglas (G'tham)
Ottaway, Richard


Horam, John
Page, Richard


Hordern, Rt Hon Sir Peter
Paice, James


Howard, Rt Hon Michael
Patnick, Sir Irvine


Howarth, Alan (Strat'rd-on-A)
Patten, Rt Hon John


Howell, Rt Hon David (G'dford)
Pattie, Rt Hon Sir Geoffrey


Howell, Sir Ralph (N Norfolk)
Pawsey, James


Hughes, Robert G (Harrow W)
Peacock, Mrs Elizabeth


Hunt, Rt Hon David (Wirral W)
Pickles, Eric


Hunt, Sir John (Ravensbourne)
Porter, Barry (Wirral S)


Hunter, Andrew
Porter, David (Waveney)


Hurd, Rt Hon Douglas
Portillo, Rt Hon Michael


Jack, Michael
Powell, William (Corby)


Jackson, Robert (Wantage)
Rathbone, Tim


Jenkin, Bernard
Redwood, Rt Hon John


Jessel, Toby
Renton, Rt Hon Tim


Johnson Smith, Sir Geoffrey
Richards, Rod


Jones, Gwilym (Cardiff N)
Riddick, Graham


Jones, Robert B (W Hertfdshr)
Rifkind, Rt Hon Malcolm


Jopling, Rt Hon Michael
Robathan, Andrew


Kellett-Bowman, Dame Elaine
Roberts, Rt Hon Sir Wyn


Key, Robert
Robertson, Raymond (Ab'd'n S)


King, Rt Hon Tom
Robinson, Mark (Somerton)


Knapman, Roger
Roe, Mrs Marion (Broxbourne)


Knight, Dame Jill (Bir'm E'st'n)
Rowe, Andrew (Mid Kent)


Knight, Greg (Derby N)
Rumbold, Rt Hon Dame Angela


Knight, Mrs Angela (Erewash)
Ryder, Rt Hon Richard


Knox, Sir David
Sackville, Tom


Kynoch, George (Kincardine)
Sainsbury, Rt Hon Tim


Lait, Mrs Jacqui
Scott, Rt Hon Nicholas


Lamont, Rt Hon Norman
Shaw, David (Dover)


Lang, Rt Hon Ian
Shaw, Sir Giles (Pudsey)


Lawrence, Sir Ivan
Shephard, Rt Hon Gillian


Legg, Barry
Shepherd, Colin (Hereford)


Leigh, Edward
Shepherd, Richard (Aldridge)


Lennox-Boyd, Sir Mark
Shersby, Michael


Lester, Jim (Broxtowe)
Sims, Roger


Lidington, David
Skeet, Sir Trevor


Lightbown, David
Smith, Sir Dudley (Warwick)


Lilley, Rt Hon Peter
Smith, Tim (Beaconsfield)


Lloyd, Rt Hon Peter (Fareham)
Smyth, Rev Martin (Belfast S)


Lord, Michael
Soames, Nicholas


Luff, Peter
Speed, Sir Keith


Lyell, Rt Hon Sir Nicholas
Spencer, Sir Derek


MacGregor, Rt Hon John
Spicer, Michael (S Worcs)


MacKay, Andrew
Spicer, Sir James (W Dorset)


Maclean, David
Spink, Dr Robert


Madel, Sir David
Spring, Richard


Maitland, Lady Olga
Sproat, Iain


Malone, Gerald
Squire, Robin (Hornchurch)


Mans, Keith
Stanley, Rt Hon Sir John


Marland, Paul
Steen, Anthony


Marshal, John (Hendon S)
Stephen, Michael


Marshal, Sir Michael (Arundel)
Stern, Michael


Martin, David (Portsmouth S)
Stewart, Allan


Mates, Michael
Streeter, Gary


Mawhinney, Rt Hon Dr Brian
Sumberg, David






Sweeney, Walter
Walker, Bill (N Tayside)


Sykes, John
Waller, Gary


Tapsell, Sir Peter
Wardle, Charles (Bexhill)


Taylor, Ian (Esher)
Waterson, Nigel


Taylor, John M (Solihull)
Watts, John


Taylor, Sir Teddy (Southend, E)
Wells, Bowen


Temple-Morris, Peter
Whitney, Ray


Thomason, Roy
Whittingdale, John


Thompson, Patrick (Norwich N)
Widdecombe, Ann


Thompson, Sir Donald (C'er V)
Wiggin, Sir Jerry


Thornton, Sir Malcolm
Willetts, David


Thurnham, Peter
Wilshire, David


Townend, John (Bridlington)
Winterton, Mrs Ann (Congleton)


Townsend, Cyrll D (Bexl'yh'th)
Winterton, Nicholas(Macc'f'ld)


Tracey, Richard
Wolfson, Mark


Tredinnick, David
Wood, Timothy


Trend, Michael
Yeo, Tim


Trotter, Neville
Young, Rt Hon Sir George


Twinn, Dr Ian



Vaughan, Sir Gerard
Tellers for the Noes:


Viggers, Peter
Mr. Sydney Chapman and


Walden, George
Mr. Timothy Kirkhope.

Question accordingly negatived.
Main Question put forthwith, pursuant to Standing Order No. 60 (Amendment on Second or Third Reading), and agreed to.
Bill read a Second time, and committed to a Standing Committee, pursuant to Standing Order No. 61 (Committal of Bills).

Orders of the Day — Health Authorities Bill [Money]

Queen's recommendation having been signified—
Motion made, and Question proposed,
That, for the purposes of any Act resulting from the Health Authorities Bill, it is expedient to authorise—

(1) the payment out of money provided by Parliament of—

(a) any expenditure of the Secretary of State under the Act, and—
(b) any increase attributable to the Act in the sums payable out of money so provided under any other Act, and

(2) the payment into the Consolidated Fund of sums received by the Secretary of State by virtue of the Act.—[Mr. Malone.]

Mr. Rhodri Morgan: I wish to make some points about the credibility of a money resolution to a framework Bill such as this. The Opposition want to know how a Bill—which is essentially of a take-powers kind—which contains almost no specifics about the number of health authorities that it will create, can be absolutely definite about the savings that it will provide. Although the Bill estimates that money will be saved, it fails to show how that saving will be achieved. The Bill contains no details about how it will save £3 million in Wales; it makes no reference to where that money will come from.
The Bill contains categories of alleged savings for both England and Wales, but it does not address the major issues of a sectoral merger between the family health service authorities and district health authorities on the one hand, and geographical mergers on the other. How much money will be saved by each of those entirely separate aspects of the Bill? If the Bill is about savings, why do we have a money resolution?
That brings me to my final point: if there is a money resolution—in other words, the Government have to spend money in order to save it—is the Minister talking about a massive redundancy bill to deal with the existing chief executives of regional health authorities and those for the joint authorities which have been set up already? I hope that the Minister will respond to that point.
When the Minister sets up completely new health authorities, will the present chief executives of joint health purchasing authorities—which have already been set up on a non-statutory basis—be guaranteed their jobs? Their jobs will be remarkably similar to those which have been set up on a non-statutory basis— [Interruption.]

Madam Speaker: Order. Let us have some quiet in the House; an hon. Member is on his feet.

Mr. Morgan: Madam Speaker, I am grateful for your attempts to get a bit of 'ush—as they used to say in ray part of the world.
This is an important point because it affects directly how much the Bill will cost the Government in the short term. Will the Government give the existing chief executives of the joint purchasing authorities any kind of promise that they will retain their job after the Bill is passed, or will they have to reapply for their jobs, as I understand is the case?
Using the powers in the Bill, the Government will appoint a new board and a new chairman of each new merged health authority, and they will be entirely responsible for appointing the new chief executives. If they choose not to reappoint the existing chief executives,


there will be a massive redundancy bill. However, if they say, "In the general spirit of things, we will re-appoint the existing chief executives, although now on a statutory basis"—obviously there will be no redundancy bill. Is the calculation in the Bill of the huge cost that is to be spent by the Government to save money based on a redundancy estimate for the present chief executives of the joint purchasing authorities that are already in place, or is there an assumption, or even a promise to those chief executives, that they will keep their jobs?

Mr. Malone: There is no such assumption. The hon. Gentleman can proceed on that basis.
Question put and agreed to.

Privileges Committee

Relevant document: First Report of the Committee of Privileges (HC27)

Madam Speaker: I have not selected the manuscript amendment that the right hon. Member for Chesterfield (Mr. Benn) submitted to me. No doubt he will deploy the arguments used in that amendment in his speech this evening.

The Lord President of the Council and Leader of the House of Commons (Mr. Tony Newton): I beg to move,
That Mr. Tony Benn be discharged from the Committee of Privileges.
The motion has been tabled in response to the first special report from the Committee of Privileges of 21 November. That report is very brief; I will read it to the House in full as it sets out both the background to the motion and the arguments for it. It says:
At the meeting of the Committee of Privileges which took place on 1 November, the right hon. Member for Chesterfield, Mr. Tony Benn, drew attention to part of a speech he had made in the House on the previous day in which he had said:
'Whatever the decision of the House or the Committee, I am no longer prepared to accept the present restrictions and if I return to attend future meetings of the Committee of Privileges it is my intention to issue my personal report of those proceedings that I attend. My reports will be based on notes made at meetings of the Privileges Committee and they will be as fair and accurate as I can make them. It will be for the House to determine how to deal with that matter, but I believe that I have a duty to make my own position plain in advance. I hope that the House will understand and respect my reasons for doing so.'

Mr. D. N. Campbell-Savours: Will the right hon. Gentleman's proposal this evening apply to future meetings of the Committee of Privileges on matters unrelated to this particular complaint?

Mr. Newton: That point will probably become clear from my subsequent remarks.
The report continues:
Mr. Benn issued a summary of the meeting to the press and the public later that day. Your Committee recognises that the action taken by Mr. Benn was in consequence of his long-held belief that all proceedings of select committees whether deliberation or evidence should be open to the public. Whatever the merits or otherwise of this view we cannot condone Mr. Benn's action in publishing any report of a deliberative meeting. This is clearly contrary to the rules of the House which apply to all select committees and which only the House itself can change. Since Mr. Benn has declared his intention of summarising future meetings we have no alternative but to recommend to the House that he should be removed from the Committee forthwith.
As the right hon. Gentleman fairly acknowledged in his speech on 31 October, it is for the House to determine how to deal with this matter.
No one disputes the right hon. Gentleman's integrity or the sincerity of his view that all Committee proceedings, including deliberation, should take place in public. For that reason, I can say for myself and, I suspect, for others, that it gives me no pleasure at all to move this motion.
I must, however, also say equally clearly that, like the Committee generally, I profoundly disagree with the position that the right hon. Gentleman has taken up. I must, of course, emphasise that the point at issue here is not—this may be the point that the hon. Member for Workington (Mr. Campbell-Savours) has in mind—whether the Committee


should take some or all of its evidence in public. The House has already reaffirmed that that is a matter for the Committee itself to decide.
Indeed, in a sense it is not even the issue whether the Committee should deliberate in public, although I must say for myself and, I suspect, many others, that I believe public deliberation—that is to say, discussion in public of how to proceed, of the content of evidence heard and of the conclusions to be drawn—would profoundly damage the search for consensus which is a key factor in the public standing and influence of our Select Committees generally.

Mr. Max Madden: Will the right hon. Gentleman give way?

Mr. Newton: May I complete my remarks? Perhaps the hon. Gentleman will have an opportunity to contribute to the debate.
The essential point of the Committee's report, which underlies the motion, is that the Standing Orders of the House contain no provision for any Select Committee to undertake such deliberation in public. The House can, of course, change its rules on that, or any other matter, if it wishes, although I think that most hon. Members would agree that such a change could sensibly be contemplated, let alone made, only after a very thorough discussion of all the arguments, including the effects on the work of Select Committees.

Mr. Madden: I am grateful to the right hon. Gentleman for allowing me to intervene as I do not intend to speak in the debate, but merely wish to ask a question before he concludes his remarks. For the benefit of the House, can he give us a clear sign whether he is giving a commitment that the evidence given to the Privileges Committee will be published without undue delay? Also, if any deletions are made, who would be authorised to make them?

Mr. Newton: It has been generally accepted—certainly it was indicated on behalf of the Committee—that every expectation is that all the evidence heard would be published, subject only to excisions, which the Committee would have to agree, for example, relating to court proceedings or to what might be construed in some senses as the irresponsible use of the privilege of the Committee to make allegations against other persons for which there appeared to be no foundation. The presumption is that the evidence would be published in full. Any decision to do otherwise would have to be taken by the Committee. I hope that that is clear.

Mr. Dennis Skinner: Will the right hon. Gentleman give way?

Mr. Newton: Yes, but other hon. Members want to speak.

Mr. Skinner: In the past 20 years, many changes have been made in Parliament—starting with the Register of Members' Interests and, more recently, televising this place. Why do the Leader of the House and his friends want to keep to that old-fashioned view about Committees meeting in private? Is it not time that they came up to date?

Mr. Newton: I hope that it is clear—

Sir Donald Thompson: rose—

Mr. Newton: May I answer first, rather than be drawn into serial interventions, and then I will gladly give way to my hon. Friend.
I hope that it is clear to the hon. Member for Bolsover (Mr. Skinner), who has undoubtedly studied the report of the Committee's deliberations—the votes that took place on various motions—that the view that he attributed to me, as if I were expressing it on behalf of the Government, was widely shared by the majority of Committee members. I give way to my hon. Friend the Member for Calder Valley (Sir D. Thompson).

Sir Donald Thompson: My right hon. Friend answered my question.

Mr. Newton: Meanwhile, in the absence of any such changes being made by the House, surely it must be clear that such a change ought not to be brought about by one right hon. Member, however distinguished and sincere, deciding to substitute his rules for those of the House.
The Select Committee on Privileges has been asked to deal with serious issues relating to the conduct of hon. Members and the reputation of this House. It is important for the House as a whole that the Committee should make progress with its inquiries and agree a report. The Committee has found itself unable to make progress until the confidentiality of its deliberations can be assured. It has accordingly asked the House to change its membership and the motion that we are debating has been moved at the Committee's request. For that reason, I ask right hon. and hon. Members on both sides of the House to support the motion.

Mr. Tony Benn: I am grateful to the Leader of the House for the spirit in which he moved the motion and the words that he used. I ask the indulgence of the House to allow me to present a different case, which raises important constitutional questions.
The motion before the House is very simple—that I be removed from the Select Committee on Privileges on the grounds that I have written reports about the deliberations of that Committee. If the matter were as simple as that—my replacement by someone else—it would not warrant a debate, for many other Members of the House are as well or better qualified to sit on the Privileges Committee, and I make no special claim on my own behalf.
The real issue that we are debating, however, is very different, and the Leader of the House touched on it. It is whether the House should in this case reaffirm its existing practice that no report should ever be published which deals with the deliberations of the Privileges Committee. I hope to persuade the House to reconsider the matter by voting against the motion that the Leader of the House has moved. I regret the fact that the debate has come so late, as I think it raises an important matter.
May I first deal with some preliminary questions which Members are entitled to have disposed of? First, a vote against the motion is in no sense a vote against the Speaker. The Speaker asked for a report to be made to allow the House to reach its decisions in an orderly manner, and the Speaker is in no way committed to the recommendations of the Procedure Committee.
Secondly, it is a House of Commons matter, and it can be decided on its merits. The Leader of the House referred to voting, and I should like to make the same point. Three of my longest-serving Labour parliamentary colleagues voted to remove me, and Conservative Members should be quite free to reach an independent judgment on the matter.
Thirdly, the House can amend, and has amended, Privileges Committee reports, and the House is under no obligation whatever to accept the report of the Committee. For example, in 1986—I was on the Privileges Committee then, as I have been for 10 years—there was a leak from the Environment Select Committee, and the Privileges Committee recommended that Richard Evans, the Lobby correspondent of The Times, should have his Lobby pass withdrawn for six months.
As a member of the Committee, I voted against the recommendation, and I tabled an amendment which read:
Your Committee thinks it right to recommend to the House that all proceedings of Select Committees should be exempted from any protection of privilege, and that all such Select Committees be advised to conduct their business in open session and to make all their papers public when they are sent to Honourable members.
At least my position on the matter is a consistent one.
When the report was brought to the House, it was defeated following an amendment by the right hon. and learned Member for Grantham (Mr. Hogg). I participated in that debate, and I have looked at the people who voted against the Privileges Committee report. They included Mrs. Thatcher, Michael Foot, the then leader of the Liberal party, the present leader of the Labour party and two members of the Privileges Committee—the hon. Member for Calder Valley (Sir D. Thompson), who has just intervened, and the hon. Member for Hampshire, North-West (Sir D. Mitchell). Therefore, there is a clear precedent for the Committee to have its recommendations rejected.
The fourth preliminary point which I want to clear away before I come to my argument relates to reports being issued. I was not arguing in Committee about the openness of evidence, although I believe that there should be openness, but that reports should be issued after each meeting of the Committee under the auspices of the Clerk of the House.
The draft report which I moved—which the Committee rejected—very simply said:
That minutes of each meeting, covering the evidence and the deliberations of the Committee, should be prepared by an official reporter, under the supervision of the Clerk of the Committee and published as soon as possible … That individual members of the Committee should be free to comment on those proceedings as is the case with the proceedings in the House itself.
Hon. Members may wonder what will happen if the House tonight rejects the Privileges Committee report. The answer is simple—the Privileges Committee will have to think again, as it did in earlier cases. But it is open to us tonight to change the procedure if we decide to reject the report. I hope that the Leader of the House will not tell us that the procedure is so tight that even a vote tonight against the motion cannot change it. Of course it can, and that is why I am speaking at some depth on the matter.
I shall briefly recall to the House the background to the events, although I am sure that everybody is familiar with them. In July, after reports appeared in the press about the alleged payment of money to hon. Members in return for asking parliamentary questions, the House referred the matter to the Privileges Committee. As the senior member of the Committee, it was my duty to summon the Committee, which I did. I moved the Leader of the House into the Chair in accordance with practice, and he will

recall that the Committee had to adjourn rather prematurely because it had no authority to sit doing the summer recess.
At that meeting, I argued the point that I am now making—that the Committee should take evidence in public and deliberate in public. But the Committee decided to defer a decision on the matter until after the recess. On 18 October, the Committee met again, and the matter of holding evidence in public was put before the Committee. On the Chairman's casting vote—about which I make no complaint, as it was his casting vote—the Committee decided not to hear evidence in public.
On 31 October, in the light of the Committee's decision, the Opposition moved that that decision be reversed. During the course of that debate, I made the statement, which the Leader of the House quoted tonight, that I intended to publish a report of the Committee's proceedings. I do not believe in the leaking and briefing that characterises this place, where a quiet word is had in the Corridor. If you want to say it, publish it—that is the principle on which I have tried to operate.
I acted openly and honestly. I said that I would publish a report; I circulated a note to that effect to members of the Committee, as the right hon. Gentleman will remember. I was asked at a meeting of the Committee whether I intended to publish such a report. I said that I did, and I did it. I gave it to the Speaker; I gave it to the Clerk—I brought the very first copy to him—and I put it in the Library. It is still in the Library for anyone who wants to read it.
No member of the Committee complained about the accuracy of what I had written. One Government Member actually complimented me on having produced a "fair and balanced" report, which was the best that I could do.
On 2 November, Madam Speaker, without being triggered by a special question, announced that she thought that the matter was so important that the Committee should report on it. That is the basis of the report now before the House. On 21 November, the Committee met and recommended that I be removed from the Committee. That is the basis of the motion before us.
The real issue is not about me in any sense; it is about whether deliberations on this issue should be held in private. I should like to rehearse the arguments for secrecy so that hon. Members realise that I have addressed them with some seriousness.
The first argument is that the Committee of Privileges has always deliberated in secret, as have other Select Committees. The question before us is whether the Committee of Privileges should deliberate in secret in this case—I hope to show the reasons against such secrecy.
The second argument in favour of secrecy is that it would be unfair to witnesses for the Committee to be held in public. Many witnesses, however, would want to heard in public—perhaps the Committee would not want to hear them, but I will not go into that now.
The third argument is that public hearings would make a media circus of the proceedings. For heaven's sake, what have we had but a media circus on this matter from the very beginning? The fourth argument is that public hearings might lead to a breach of natural justice. I heard one hon. Member describe the editor of The Guardian as a "whore out of hell" under the protection of privilege. If natural justice is breached, it can be breached in the House as well.
The fifth argument in favour of secrecy is that the evidence would be published later, so what does it matter? Under present practice, however, the deliberations of the Committee will never be reported.
The sixth argument, the most extraordinary one of all, was put by the right hon. Member for Old Bexley and Sidcup (Sir E. Heath), who said that members of the Committee would not feel free to speak their minds if they knew that they were to be reported. The House has debated the matter twice, on 13 July and 31 October, and I never saw any sign of hon. Members being inhibited from commenting. In this case, there cannot be a difference between the Privileges Committee and the House.
People think that it is the evidence presented to the Committee of Privileges which is interesting; for my part, it is not. What is interesting is how senior Members of the House approach the problem before them. From the point of view of the public, it is an understanding of the workings of the Committee which I have always found so interesting and which makes me rather sorry that I may not remain as a member of that Committee.
I do not accept any of the arguments for secrecy. Reports are often made about discussions of other Committees, even Cabinet committees—what was Bernard Ingham doing for years but briefing people on what had happened? Indeed, some Labour party committees of which I have been a member have very occasionally leaked. I cannot really accept that the need for secrecy is a valid argument. Why should the Committee of Privileges be so uniquely protected?
I believe that the issue before us is of unique importance, and it is uniquely important that the public should know what individual members of the Committee say about issues before it, as well as hearing their conclusion.
The Nolan committee, which the Prime Minister announced, will cover much of the same ground as the Committee of Privileges, including the secondary part of our inquiries. I understand that it will be holding public hearings, and I hope to give evidence to it.
I come now to the cases before the Committee. The media had been, and have been, publishing reports that suggested that there may have been bribery, corruption, fraud, blackmail and forgery involving Members, directly or indirectly. I do not know whether those allegations are true, but one thing is certain; those charges have gravely damaged the democratic process, and I shall tell the House why. Some of our constituents may now be wondering whether, when they elect Members of Parliament to represent them, some of the Members that they have elected—only a tiny minority, but some of them—may have been using their position not to represent their constituents but to peddle their influence for money.
That is what makes it a uniquely important question. Were such a suspicion to become widespread—I very much hope that it would not—it could completely undermine the basis of trust between the electors and Members of Parliament. I think, and I say to the House, that it must face the fact that there is legitimate concern on that score—a concern that is deepened by the apparent determination of the House not to allow its deliberations to be known.
I shall now discuss another aspect of the matter. 'That is that there is in this case a straight conflict of loyalty between our duty as Members of Parliament to those

people who elected us, and our obligations to follow the conventions of the House. Parliament cannot survive if it is a closed little club to which all Members of Parliament are supposed to transfer their allegiance as soon as they come here, because it is a fact that our first responsibility must be to those people who sent us here. I think that, if we subordinated that responsibility to ancient conventions of the House, we should be betraying the trust put in us by those who elected us.
If I were to accept the conventions that the House apparently wishes to impose again tonight, consider what I would be doing. If someone wrote to me from Chesterfield and asked, "What is being said on the Committee about these cases?" I would say, "I cannot tell you." Even if they said to me, "What are you saying on the Committee? Tell me", I could not tell them, because the restrictions cover my own reporting of my own comments in the Committee.
How can I possibly accept such a restriction? The right—[Laughter] I am sorry, but that is the view. Hon. Members can laugh; they often do laugh, and I shall come to some examples of the punishment that they have imposed on people who have tried to argue that case in earlier centuries.
It would be a wholly unacceptable limitation, not on my rights—I have no rights in the matter—but on the rights of those who elected me, to know what is being done in their name. With all the talk about free—

Sir John Gorst: rose—

Mr. Benn: I shall just finish this paragraph; then I shall give way.
With all the talk about open government and freedom of information and league tables, is the House of Commons Privileges Committee to say that it will not move? I think that the House had better take seriously the arguments that I am putting forward, because they are serious arguments and I believe that they are very widely shared by a lot of people, judging by the enormous amount of mail that I have had on the matter, from many people who have said, "We have never agreed with anything that you have ever said before in your life, but on this question, we believe that you are right."

Sir John Gorst: What is the difference between the example that the right hon. Gentleman has given and, for example, a constituent of the Prime Minister asking him to reveal what took place in Cabinet? It might be argued that, after all, he elected the Prime Minister; why should not the Prime Minister have the same obligation to him as the right hon. Gentleman claims for his constituents?

Mr. Benn: All Prime Ministers employ hundreds of press officers to tell their constituents what a marvellous job they are doing. [HON. MEMBERS: "Oh".] Well, one has to accept the fact. However, there is a total difference: between the two cases. If one is here as a Member of Parliament representing one's constituency on a House of Commons matter, one's duty is to them. If one is the Head of a Government, one has to justify what one's Government have done. I think that the hon. Gentleman has made an error.
I now come, if I may, to the attitude to the cases that are before the Committee. First, there are different ways to consider how the matter should be approached. The first way is trial by media. Stories of sleaze and scandal


may help to sell newspapers and boost circulation, and I suspect that that is why they have had such extensive coverage, but that is no basis for tackling the matter.
Secondly, there could be trial by Members of Parliament. There is another view, which I think may have influenced some of my colleagues—it even came out in part in the speech of the Leader of the House—that the House of Commons should somehow proceed as quickly as possible to deal with the matter. I think that some Opposition Members think that what I have done is to delay their opportunity to expose some Government Members for political advantage.
I do not take that view. As I shall show, the matter should not be handled by the Committee of Privileges at all. I believe that what is at issue is the reputation of the House of Commons as a whole. The most serious criticism of all that can be levelled in relation to this subject is against the House for setting such low standards and for failing to maintain them, raise them or do anything about the problem.
On the subject of individual Members, as I told the Leader of the House, I am not a muck raker by instinct. I am not so interested in what hon. Members have or have not done, but I am interested in how the House of Commons could have allowed a situation to develop in which it is apparently possible for such things to be done within the standards that we have accepted.
I shall tell the House what I believe the Committee should do, as I might not be there to argue the case when the report is made. First, the House should decide that service in the House of Commons is a public service, and that the use of parliamentary influence in return for payment should itself be treated as a breach of privilege.
Secondly, the principles that underlie the rules applying to Ministers—which apply to the Leader of the House and which applied to me for 11 years—should, with suitable amendments, be applicable to every Member of Parliament. One of those principles is that there should be no conflict between the private interests of Members and their public duty.

Mr. Tim Devlin: On a point of order, Madam Deputy Speaker. Does what the right hon. Gentleman is now relating to the House fall within the terms of the motion?

Madam Deputy Speaker (Dame Janet Fookes): It is going fairly wide, but I trust that the right hon. Member for Chesterfield (Mr. Benn) will keep within the terms of the order.

Mr. Benn: Madam Deputy Speaker, not only am I not going wide of the order, but I am giving reasons why I should not be removed from the Committee of Privileges by saying what I believe the Committee should do in the circumstances. That is why I should like to serve on the Committee, and that is what I would say were I on it.

Mr. Bill Walker: I thank the right hon. Gentleman, and I am glad to see that he is wearing his Royal Air Force Volunteer Reserve tie. I am listening carefully to what he is saying—as, I am sure, are all hon. Members, because we all care as deeply as he does about the way we conduct our proceedings.
First, is the right hon. Gentleman saying that if, in future, an hon. Member writes regular columns for a newspaper and uses material to which he has had access because he is a Member of the House, that would be excluded? Secondly, does the right hon. Gentleman accept that some Conservative Members, myself included, wrote to the Speaker to ask for the matter to be referred to the Committee of Privileges because of the behaviour of the newspaper person who came here? If so, has the right hon. Gentleman taken that on board in his considerations?

Mr. Benn: Peddling one's position as a Member of Parliament to buy political influence for a private employer is totally different from the case that the hon. Gentleman makes. If the hon. Gentleman takes that view, it is permissible—all my papers have been given to the British library in any case—[Interruption.] If that is his argument, I do not think that it merits any serious consideration—[Interruption.]

Madam Deputy Speaker: Order. I think that the House knows my view on seated interventions.

Mr. Benn: Thirdly, the powers to investigate hon. Members who breach the rules should be transferred to a court, as happens with contested election petitions. The House may know that, in the 19th century, when an election was contested or bribery was alleged, an election committee, like the Committee of Privileges, would meet. But that election committee always voted with the majority party in the House, and the House wisely decided to transfer the power to judges in an election court. Two judges sat without a jury and reported to the House, which acted on their report. The matter under discussion should be dealt with in the same way.
Legislation should be introduced to enforce the rules by extending the list of offices that lead to disqualification—from Government contractors to those who peddle their influence for money. That should be dealt with by statute. It should be illegal for any outside organisation to pay Members to exercise their influence in the way that has been alleged. If I paid an elector to vote for me, I would be guilty of bribery and would be unseated from this House. I see no difference—

Mr. Devlin: On a point of order, Madam Deputy Speaker. Seriously, this is not in order. The motion relates to whether the right hon. Gentleman should be discharged from the Committee. I am sure that we are all fascinated by what the right hon. Gentleman has to say about how Parliament should be run, but surely that is a proper subject for a newspaper article, not for this debate?

Madam Deputy Speaker: Before the right hon. Gentleman continues—[Interruption.] I do not expect hon. Members to intervene when I—or any other hon. Member—am speaking. The right hon. Gentleman has certainly been deploying his case in some detail. I hope


now that he will stick rather more closely to the terms of the motion, also bearing in mind the fact that this is a short debate, and that others will wish to speak in it.

Mr. Benn: I do not know whether you recall it, Madam Deputy Speaker, but I made the same points in the debate on 13 July—

Madam Deputy Speaker: Order. I can deal only with what is before me now.

Mr. Benn: The reason why I repeat them—

Mr. Skinner: Further to the point of order, Madam Deputy Speaker. My right hon. Friend is putting a case in defence of remaining on the Committee. In the process, he is being threatened by Tory Members, and seemingly by you, with the idea that, if he does not shut up, he will be gagged. That says something about this place, that does.

Madam Deputy Speaker: By long-standing practice, our speeches should be relevant in this place. While it is perfectly permissible to sketch in some background, it is a different matter when the background becomes the foreground.

Mr. Benn: I do not want to fall out with you, Madam Deputy Speaker, but I am explaining how the contribution that I wish to make to the Privileges Committee justifies my remaining on that Committee.
I shall finish with the recommendation that I shall make to the Nolan committee, if it will hear me, even if I am thrown off the Committee of Privileges. In addition to the Register of Members' Interests, I believe that every parliamentary candidate should register his interests, and returning officers should send those interests out to every elector with the polling cards, so that people can know these things before they vote.
If the motion to remove me is agreed to, I shall still be able to submit the same points to the Nolan committee, and I shall also be allowed to speak once the Privileges Committee report is finally published.
It is for the House to decide what to do about the actions that I have taken. If it decides to remove me, I shall make no complaint. I ask for no special favours. If I am guilty of anything, I am guilty of the same offence that has been repeated century after century when people have tried to bring the activities of Parliament to public attention. In the 17th century, Members who circulated their own speeches made in Parliament were punished. Dr. Johnson never came to the House: he bribed officials to help him write his parliamentary reports. Cobbett and Hansard were put in prison.
The truth is—I know it is painful for the House to recognise—that most of the improvements to our democracy have been made by people on principle breaking the rules. I hope that the House will be persuaded to change—

Dame Jill Knight: All this was surely just as true when the right hon. Gentleman first joined the Privileges Committee. The rules on secrecy were exactly the same then, so why has it taken him all these years to make this stand?

Mr. Benn: I shall give the hon. Lady the simple reason. There has never been a case of bribery, fraud, corruption, blackmail and forgery brought before the Committee until

this date. The hon. Lady spoke about breaking the rules. She would not have the vote if the Pankhursts had not chained themselves to the railings.
The House often has to face the fact that unfair rules are contested. My experience of the political process is that the last people to get the message are those in the House of Commons itself. The message is fully understood. The hon. Lady would not have the vote but for the suffragettes. In a modest and non-controversial way, I am pushing the conventions.

Mr. Bill Michie: I had not intended to intervene in the debate, although I shall support my right hon. Friend. I am a little worried about the line that he is taking of a one-man campaign against the abuse of this place and the ineffectiveness of the Committee. I remind the House that other people on the Select Committee feel just as strongly, and take the line that the proceedings should be in public. I do not disagree with my right hon. Friend for taking that line, as long as he makes it quite clear that he is not the only one on the Committee who holds a principle and has a judgment on how this place and the Committee should be run.

Mr. Benn: I am grateful to my hon. Friend for voting for me, but they are not trying to remove him from the Committee. I have to defend myself because mine is the only name on the Order Paper. My hon. Friend wanted to resign from the Committee, but I was opposed to that because I believe that one should stay on and fight one's corner. That is the difference between us, and it is an appropriate point.
Constitutional reform is moving to the top of the political agenda, and the House might inch cautiously towards a reform of its own procedures. If the House decides to retreat again behind the traditional practice of deliberating in secret, it will be a great mistake and will damage the House.
Hon. Members will have to decide on a free vote. I say openly to the House that I would not feel able to continue to be a member of the Privileges Committee if it was to be a condition of my membership that the practice of secrecy was to be maintained and I could not tell my constituents what I was saying in the Committee.

Dr. Robert Spink: rose—

Mr. Benn: I am not giving way.

Dr. Spink: On a point of order, Madam Deputy Speaker. The right hon. Member for Chesterfield (Mr. Benn) made accusations of crimes and corruption such as fraud and blackmail which be believes have taken place. If he believes that and does not come to the Committee with an open mind, would he be a proper person to sit on the Committee?

Madam Deputy Speaker: If I had thought that the right hon Gentleman was out of order when he made the point, I would have intervened.

Mr. Benn: The hon. Gentleman was not listening. said "charges" of bribery, fraud and blackmail, and expressed no judgment on the matter. I have not associated myself with any of them.
For all the reasons that I have given, I ask hon. Members to reject the motion, and invite the Committee of Privileges to think again about a matter that may be rather more serious for our electors than the House itself seems ready to accept.

Sir Terence Higgins: On 2 November Madam Speaker stressed that the behaviour of the right hon. Member for Chesterfield (Mr. Benn) had implications that were of great importance for Select Committees generally. Therefore, I should like to speak on that matter, because as Chairman of the Liaison Committee I entirely agree with Madam Speaker and feel bound to say that the view expressed by the right hon. Gentleman has many dangers.
Much of what the right hon. Gentleman said was not to the point, which is simply whether Select Committees deliberate in public and in particular whether the actions of one member should be allowed to override the decision of the Committee and the rules of the House. He put forward various reasons why he thought that should be so.
In many ways this is a sad occasion, because the right hon. Gentleman has done great service to the House. I can think of no one who, in listening to some of his speeches, has given me more delight. He has a keen mind. However, I feel bound to say that on this occasion he is fundamentally and profoundly wrong.
It is important that hon. Members should be allowed to deliberate in private, for the simple reason that they may change their minds. They may be persuaded by the arguments. When the right hon. Gentleman goes into a Committee it is virtually inconceivable that during the course of the deliberations he may change his mind.
The real point that I want to make is that it is through deliberations in private that Committees reach a consensus. The reality is that over recent years we have introduced a system of departmentally related Select Committee which have been a great improvement in getting the Government called to account. One of the strengths of those Committees has been the fact that they have produced unanimous reports. We all know that a Committee's report is far more likely to have influence and to call the Government to account if it is unanimous than if it splits along party lines.
It is a difficult process. Hon. Members have to listen to all the arguments in the light of the evidence they have taken, very often in public, and then weigh the arguments and persuade each other of the right outcome.

Mr. David Winnick: Is the right hon. Gentleman aware that a number of hon. Members, including me, who believe, and voted accordingly, that the Committee should be open to the press and public, nevertheless accept—and here I disagree with my right hon. Friend the Member for Chesterfield (Mr. Benn)—that its deliberations should be in private, and for very much the reasons stated by the right hon. Gentleman?
Does the right hon. Gentleman recognise that there are those of us who strongly believe, no less so than my right hon. Friend, that the proceedings should be in public, but equally strongly believe that to have the deliberations and the reaching of conclusions in public would be like a jury

reaching its decision in public? I hope that the right hon. Gentleman understands the distinction between the two views.

Sir Terence Higgins: The hon. Gentleman and I are reaching a consensus, and one which I hope is widespread throughout the House—so much so that the right hon. Member for Chesterfield is alone in the position he holds.
Committees must reach a consensus and it would be difficult to do so in public, not least because very often the view, the process and the consensus are not what the Government want. We do not really want the Whips listening to every word said during the deliberations.

Mr. Campbell-Savours: The right hon. Gentleman said that he would not necessarily like the Whips to listen. May I put to him a problem in the Select Committee on Members' Interests? A Whip has now been appointed to that Committee. Its very credibility is completely undermined. Will he oppose that appointment?

Sir Terence Higgins: That is a separate issue that the House might wish to consider. I feel bound to say to the hon. Gentleman— [Interruption.]
Madam Deputy Speaker: Order. As the hon. Member for Workington (Mr. Campbell-Savours) has just intervened, I do not now expect a sedentary intervention from him.

Sir Terence Higgins: The hon. Gentleman made an important point that the House might wish to consider on another occasion. I have considerable sympathy for his view.
Much of what the right hon. Member for Chesterfield said related to and was a repetition of what was said in the debate on whether the Privileges Committee should take evidence in public. It did not relate to whether the Committee should deliberate in public. The right hon. Gentleman takes a partisan view about everything.

Mr. Skinner: What is wrong with that?

Sir Terence Higgins: I shall tell the hon. Gentleman what is wrong with that: this House does not carry out its duty as effectively and efficiently as it should if all its work is done on a party political basis. It is not true to say that there are no issues on which we can reach a consensus, and everything must be done on a party political basis. The right hon. Member for Chesterfield and the hon. Member for Bolsover (Mr. Skinner) both take that view, but I do not share it. The House does not carry out its democratic duties as efficiently if it decides that everything must be done on a straight—I feel bound to use the word "hack"—party political line. The operation of Committees has been much more effective as a result of reaching a consensus.
The rules of the House have been refined over many years, so there is much to be said for them. At the same time, if there is to be a change, the House must debate it and reach a conclusion on it. But the right hon. Gentleman sought effectively to hold the Committee and the House to ransom. Whatever else the House and the Committee might want to decide, the right hon. Gentleman thinks that his views should prevail. That is not a modest approach to the issue. Once the House has considered the matter, as it should, it will conclude that the arguments for continuing to deliberate in private are extremely strong—in my view, they are overwhelming.
Those who truly have the House's interests at heart will not take the view expressed by the right hon. Gentleman this evening. It is right that the House should vote in favour of the motion and he should be removed from the Committee, sad though I find it, because few people have made such a notable contribution to the House.

Mrs. Ann Taylor: I wish to make just a few observations on the motion, without discussing the specific case with which the Privileges Committee is currently dealing.
I much regret the fact that the House must debate this motion and that the Privileges Committee has found it necessary to refer the matter to the House. I regret the fact that the position of my right hon. Friend the Member for Chesterfield (Mr. Benn) has become the focus of attention, rather than the normal workings of the Privileges Committee and the serious allegations into which it should have been inquiring before now. Everybody should regret the delay that has taken place between July and this issue now coming to light, given that the Committee has not yet had an occasion on which to examine the substantive issue. Had the House accepted the motion which we tabled on 31 October, this would not have arisen and it would not have been necessary to debate the motion moved by the Lord President.

Mr. David Alton: I welcome what the hon. Lady has said so far. We are in danger of fighting the last battle in the wrong ditch. Much of what has been said this evening has ensured that the scent has gone cold in terms of the original allegations about which the House should be concerned.
The hon. Lady says that we could have united on the Labour party motion, on which I agreed with her and for which I voted at the time. Did not that distinguish between evidence sessions and deliberative sessions? That is the point before the House tonight, but we are now being invited to open up the whole proceedings, including the deliberative sessions, on which there is no unanimity.

Mrs. Taylor: The hon. Gentleman is right, and I remind the House that the motion that we tabled suggested that the Committee of Privileges should exercise its power under Standing Order No. 108, so that when examining witnesses it would sit in public except for clear and compelling reasons. Our motion did not ask for the Committee's deliberations to be in public—although in fairness to my right hon. Friend, he made his personal position clear in the debate on that motion.
If the House had accepted that motion, the Committee would have been able to reach agreement and my right hon. Friend would not have been moved to issue the document that he did, following the first sitting of the Committee.

Sir Jim Spicer: The right hon. Member for Chesterfield (Mr. Benn) made it clear throughout the Committee's deliberations that he would not accept anything short of its deliberations being made public—and the right hon. Gentleman has followed that independent line. Who is to say that he would not have gone down that road even if the House had accepted the motion?

Mrs. Taylor: Some of us are at a disadvantage because we are not members of the Committee of Privileges, and

the whole House is at a disadvantage because of the ruling that we cannot be party to all the Committee's decisions and discussions. If the House had accepted the motion on 31 October, the atmosphere in which the Committee operated would have been different and less divisive, and it would not have become a partisan issue.
I share the regret expressed by the right hon. Member for Worthing (Sir T. Higgins) that there was united opposition to the motion on the Government Benches. We tabled the motion in the hope of securing recognition of the validity of our argument, not to divide parties. We tried to be reasonable, and if that motion had been passed and evidence was taken in public, the whole issue might not have arisen.

Sir Terence Higgins: I did not make the remarks that the hon. Lady attributed to me. I clearly expressed the opposite view.

Mrs. Taylor: I confused the right hon. Gentleman with the hon. Member for Dorset, West (Sir J. Spicer).
The totality of opposition among Government Members to the 31 October motion made this a partisan issue, and that has not proved beneficial to the subsequent work of the Committee of Privileges or to subsequent debates on the Floor of the House.
It is unfortunate that the basic allegations that are the subject of the Committee's inquiries and public concern about them have been pushed to one side and that my right hon. Friend has become the focus of attention.

Sir Cranley Onslow: The allegations have been pushed to one side only because the right hon. Member for Chesterfield (Mr. Benn) insisted on being the focus of attention. If he had kept quiet, we could have got on perfectly well.

Mrs. Taylor: If our motion had been agreed to on 31 October, the allegations would have been discussed much more quickly.
My right hon. Friend's conduct and decisions were undertaken without consulting my right hon. and hon. Friends, but I respect my right hon. Friend. As others have said, he has strong feelings and a strong feel for parliamentary traditions. He also understands well that it is sometimes necessary to kick at those traditions to bring about change. The question before the House is whether my right hon. Friend's unilateral action justified delaying the Committee's inquiries, which was the consequence of his action.
It is difficult to determine the Committee's position because its members are not allowed to leak its discussions. I understand, however, that the Committee of Privileges has not yet finalised its decisions on how to proceed with the examination of witnesses, nor has it excluded the possibility of hearing witnesses in public. If that is indeed the case, my right hon. Friend's actions have been pre-emptive, in that he has not exhausted all the opportunities to ensure that the Committee meets in public for at least part of the time.
As for the debate about whether the Committee's deliberations as well as its taking of evidence should be public, I should make my position clear. I believe that evidence of the kind that the Committee of Privileges will need to take should, whenever possible, be taken in public. That was the essence of the motion that we tabled


at the end of October—although we made provision for the Committee to hear evidence in private if there was good and compelling reason for it to do so.
Personally, I do not think it best for the deliberations of a Select Committee to take place in public. I support the view expressed a few moments ago by my hon. Friend the Member for Walsall, North (Mr. Winnick): I think that the position is very similar to that involving juries, and I do not think that it would be helpful to the workings of Committees to make their deliberations public.

Mr. Robert N. Wareing: Will my hon. Friend make an exception? Let us suppose that a vote was taken during a deliberative Committee meeting. Could I tell my constituents that during a meeting of the Select Committee on Foreign Affairs, when we discussed the Pergau issue, I voted in favour of Lady Thatcher and Charles Powell being brought before the Committee? Does my hon. Friend agree that, if a partisan vote takes place in a Committee, it should be published?

Mrs. Taylor: I think my hon. Friend will know that votes taken on such Committees are made public—although not necessarily immediately; that may be his point. Certainly the deliberations of such Committees are not made public, and I feel that that might inhibit valuable discussion.
My right hon. Friend the Member for Chesterfield said that tonight's vote should be a matter for the House, not a question of party affiliation. I think that his comments about the way in which his colleagues have already voted on the question of his remaining a member of the Committee show that Opposition Members on the Committee did not treat this as a partisan matter, and I believe that they will not do so this evening. Opposition Members view this as a genuinely free vote, and I hope that Conservative Members will approach it in the same way—although I must say that there has been some disappointment about the unanimity of their voting on all issues relating to the Committee of Privileges in recent months.
My right hon. Friend the Member for Chesterfield pointed out that the House was not obliged to accept a report from the Committee of Privileges. That is true, as were other technical comments that he made, but I take issue with one of his remarks: he said that if the House supported the motion, no reports dealing with deliberations should ever be published. Whatever the outcome of tonight's vote, the House can always make that decision at any subsequent date, and can always recommend to any Select Committee—including the Committee of Privileges—that such deliberations should be made public in future.
My right hon. Friend has drawn a distinction between the conventions of the House and the interests of those who elect us. I do not think that there always has to be such a distinction. My right hon. Friend had not exhausted all the possible ways to get part of what he wanted out of the Committee of Privileges—the part of our resolution moved on 31 October relating to the examination of evidence in public. I still believe that that is the most important objective. I know that my right hon. Friend, who has raised some serious issues, wants to ensure that the public interest is defended, but, although I sympathise

with his intention, I cannot support his tactics. He has not explored all the possibilities for getting what is in the public interest.
It would be overridingly in the public interest to have the relevant parts of the Privileges Committee sitting in public. I am afraid that my right hon. Friend's actions have not helped to achieve that objective. The Privileges Committee has not reached a final decision and I still hope that it will be able to consider the widespread anxiety outside the House about the allegations, the issues raised in the debate on 31 October and the possibility of taking at least some evidence in public in order to restore public confidence in the Privileges Committee and in the House.

Sir David Mitchell: We have a curious situation. The right hon. Member for Chesterfield (Mr. Benn) is recognised as a distinguished, if at times eccentric, parliamentarian. This is one of his eccentricities. He is in this place because he was democratically elected with a majority of 6,414 by the electors in his constituency. He accepted that it was right that the views of a majority of them should prevail and send him to this place, just as each of us has been sent here by a majority of our electors.
The right hon. Gentleman arrives in this place by a democratic process but then behaves as an autocrat—all but he must abide by the majority decision. He is part of a Committee that the House democratically agreed under its rules should deliberate in private. The right hon. Gentleman accepts democracy when it suits him but rejects it when it suits him. That is the road to anarchy,

Mr. Bill Michie: rose—

Sir David Mitchell: I shall not be long; the hon. Gentleman will have the opportunity to catch your eye, Madam Deputy Speaker.
As I said, that is the road to anarchy. If we vote tonight—and it looks as if we shall—on whether to remove the right hon. Gentleman from the Committee, I shall vote in favour but with great regret because I think that the Committee would have been all the better for having the benefit of his advice. However, he cannot come to the Committee having been elected as a democrat and then not abide by the democratic process.

Mr. Peter Shore: I greatly regret the withdrawal or loss of my right hon. Friend the Member for Chesterfield (Mr. Benn) from the Select Committee on Privileges, not least because he enlivens its proceedings and, more important, brings to its deliberations his intelligence and his talents and great experience as a parliamentarian. The Committee will be the poorer for his loss.
The central point, however, is a simple one: there is a division, still unresolved, among members of the Committee as to whether we should take evidence in public. It is no secret that that that is the view taken by members of my party. We have very strong views about that. Making committee deliberations public is a minority view. I think that my right hon. Friend, who normally approaches matters with great clarity, confused the two issues in his speech. We all know that it is common


practice for Select Committees to hear evidence in public, but I know of no Select Committee—let alone the Privileges Committee— which deliberates in public.
My right hon. Friend mentioned the Nolan Committee in order to bolster his case, but he has not done that. I am a member of the Nolan Committee and I hope that most of the Committee's evidence will be heard in public— I am sure that is what Lord Nolan would wish—but there has been no suggestion that the Committee should deliberate in public and, so far as I know, we have no intention of so doing.
Although analogies are very difficult in this area, I think that the courts and the trial process offer at least a rough guide. As my hon. Friend the Member for Walsall, North (Mr. Winnick) said, evidence is taken from witnesses in public, and that is as it should be, but when the jury retires there is no report of the discussion that takes place. Common sense dictates that certain issues should be discussed with others privately in the hope of having a very frank exchange and reaching agreement.
In conclusion, to mix up the two issues is to do the House a disservice. The issue of whether witnesses should be heard in public is quite separate from the issue of whether Committees' deliberations should be reported as they proceed—let alone that members of the Privileges Committee should be entitled to make a running commentary on the proceedings as they develop.

Sir Peter Emery: I am particularly sorry that the right hon. Member for Chesterfield (Mr. Benn), who I think is the oldest serving Privy Councillor in the House, should find himself in dispute with a Committee on which he has served for 12 years. He has never found it necessary to make this point before now.
The right hon. Member for Dewsbury (Mrs. Taylor) suggested how the vote on the matter should proceed, and I think that all hon. Members agree with her. Everyone wants it to proceed as quickly as possible—not least the people concerned, who have obviously had a very unpleasant time while the matter has been hanging over their heads.
The right hon. Member for Chesterfield tried to raise emotions about the matter by comparing it with Hansard or Mrs. Pankhurst. That is somewhat ridiculous, to put it mildly. There is a difference between the way in which Select Committees work and the way in which matters on the Floor of the House operate. On the Floor of the House there is an obvious political divide which is seen time and again in the Division Lobbies.
I have served on Select Committees and I have been Chairman of the Procedure Committee for the past 12 years. It is amazing how much members of a Select Committee work together to try to produce a completely unanimous report, because they know that such a report will have a specific effect. There is a great difference between the political operation of proceedings on the Floor of the House and the operation of Select Committees upstairs.

Mr. Bill Michie: Will the right hon. Gentleman explain why, when we debated and voted on whether parts of the Select Committee's investigation should be made public, on a tied vote, the Committee Chairman gave status quo as a reason for voting to keep the investigation private? As as I understand it, there is no status quo for a Select

Committee. There is certainly no politics involved. To this day, it has never been explained to me why the Chairman took that view.

Sir Peter Emery: I believe that I speak with some little authority on this. On the whole—I do not say without exception—the Chairman of a Committee will vote in one of two ways. He will vote either to have the matter heard again or to stay with the way in which the matter has proceeded until that moment. I cannot tell what was in the mind of the Chairman—the hon. Gentleman must ask him and not me—but those are the two matters that a Chairman would normally take into account.
I need not go over the difference between the taking of evidence and a Committee's deliberations. That has already been thoroughly debated. There are, however, times when all the evidence should not be taken in public, especially if, as may well have been the case in this Committee, one wants to cross-question a witness at some length. It seems, therefore, much more sensible not to have half the evidence come out when there is still as much cross-examination again to take place at a later sitting. That problem is real and must be considered. It must be understood, however, that the Committee can decide: the House should not be the decider of that matter—it should be left to the Committee, the people considering the situation, to decide.
That point leads me to one of the most deliberately misleading points in the speech by the right hon. Member for Chesterfield. He has suggested that there is a degree of secrecy and he seems to feel that something is going to be covered up. In my judgment, that is not the way in which the Committee of Privileges has worked in the past. In previous reports from the Committee of Privileges, the evidence has been published and the cross-questioning has been published. The public have been able to see exactly what has gone on in the evidence-taking.

Mr. Doug Hoyle: On a point of order, Madam Deputy Speaker. The right hon. Gentleman has used the word "see". The relevant word is "read", not "see". We are talking about "reading" as well as about "seeing" and "hearing".

Sir Peter Emery: I am willing to be taken to task on that matter. I am saying that members of the public can see in the writings and the publications exactly what has taken place. There is no secrecy or no cover-up in that. That is the major point. There is no way in which the House will stop a debate on the report. It will come to the House and will be debated fully. I have no doubt that the right hon. Member for Chesterfield will speak again in that debate. He will have that right and nobody will stop him from doing so.
The Select Committee on Procedure has looked at the matter in a slightly different way. It has considered not the deliberate leaking of information by a member of a Committee, but the unofficial leaking of matters considered by the Committee and the deliberations of a Committee. Paragraph 225 of the report, "The Workings of the Select Committee System," from the 1989–90 Session says:
publication causes even more immediate harm, in that it can affect the way in which the Committee subsequently deals with the Report. Sometimes that is exactly the intended effect—motivated perhaps by a desire to marshal support for, or more likely against, an individual recommendation or set of conclusions. On other occasions the aim of a leak may be to ensure that a particular extract from a draft


Report … will leave the desired political impression on the public consciousness, an impression which may not be erased when the Report is eventually published formally.
Paragraph 226 of the report states:
leaks … are subversive of the Select Committee system as a whole and are therefore, quite apart from being wrong in principle, extremely short-sighted.
What worries me is that, if the right hon. Member for Chesterfield won the vote tonight, the working of every Select Committee would be affected. The secrecy of deliberation is all-important. Anyone who has served on a departmental Select Committee knows the arguments that take place between members, often across party lines, before the recommendations are made. If those arguments took place in public, it would massively alter the way in which members argued their case during the Committee's deliberations.

Sir John Gorst: If what my right hon. Friend describes were to take place, the result would be that most Select Committees would reach their conclusions by means of private deliberations in the corridors outside the Committees.

Sir Peter Emery: That is exactly the point, and that is the last thing that I want.
There is an overwhelming case to support what my right hon. Friend the Leader of the House suggested. It would be wrong to allow an individual to alter the procedures for the workings of Select Committees. Those procedures have stood the test of time and there is no way in which secrecy could be maintained. The public will know exactly what has happened and they will know the recommendations.
It is essential that we pass the motion, for the defence of Select Committee proceedings.

Mr. David Winnick: There will be a vote and I shall be voting against the motion, but I accept that the Committee faced a difficult decision. I accept that my right hon. Friend the Member for Bethnal Green and Stepney (Mr. Shore) and my right hon. and learned Friend the Member for Aberavon (Mr. Morris) realised the difficulties; hence their reason for voting with the rest of the Committee.
The Committee was faced with a difficult decision because it would have been difficult to proceed if one member—my right hon. Friend the Member for Chesterfield (Mr. Benn)—because of his integrity, as the Leader of the House stated, decided to do as he promised in the House. In those circumstances, the Committee clearly could not proceed and I understand the reasons.
I understand the reasons, so why do I intend to vote against the motion? The explanation is simple and clear. Evidence to the Committee should be in public and the deliberations should be in private. I am strongly of that view—no less strongly than my right hon. Friend the Member for Chesterfield.
The allegations made against some hon. Members are serious. Hon. Members on both sides of the House think that the standing of the House is in question and that is a matter of great concern. Outside, people feel that there is sleaze and that Members of Parliament are on the make—not just some Members, but virtually all of us. It is

important for the public to understand that that is not so. If some hon. Members have behaved in a way that they should not have, it does not mean that the rest of the House of Commons should be viewed in the same light, but we do not know if that is so, as it is up to the Committee to decide and report to the House.
I cannot for the life of me understand why the evidence should be heard in private. The right hon. Member for Honiton (Sir Peter Emery) asked why some hon. Members said that the Committee's deliberations will be secret, as the reports will be published. Of course they will—that is not in dispute—but, in the main, people outside this place will not see those reports. They will be seen only by parliamentarians, the press and those who take the closest possible interest in public affairs. Our constituents will not go to the public library or write to the Vote Office to ask to see the report.
If the evidence is taken in public, it will be reported and filmed, as my hon. Friend the Member for Warrington, North (Mr. Hoyle) pointed out. People will see it on the television screen and judge accordingly. That is why it is important.

Mr. Edward Gamier: I fondly, and perhaps naively, think that we are interested in justice and truth. In the hon. Gentleman's argument, is there not a danger that we will lose sight of that justice and truth?
In allowing the publication of evidence as it is given, one will inhibit the finding of truth and justice because newspapers will report tendentiously and partially. In a court—where evidence can be given in open court—the judge can control the errant journalist who misreports the court. The Committee will not have such powers, and surely there is a danger—

Madam Deputy Speaker: Order. Interventions should be short in any case, but particularly so tonight.

Mr. Winnick: Clearly the Committee cannot be conducted as if it were a court. The argument that the hon. Gentleman is putting forward is that no evidence at all should be taken by Committees, and that is totally unacceptable.
It is necessary to vote against the motion because my right hon. Friend the Member for Chesterfield has made a stand. I shall support him tonight because I believe that the restrictions on the proceedings being televised or reported are wrong, and they can no longer be defended. The main argument in favour of the motion is basically that the Privileges Committee has always acted in this way. Of course it has, but the time has come for a change. It is important for the standing of the House. The public are no longer willing to accept the view that all of this must be in private and that, in due course, a report will be published.
I accept entirely—hence my earlier intervention—that the deliberations must be in private, and this is where I disagree with my right hon. Friend. It would be a denial of justice if the deliberations were held in public. But as far as the main work of the Committee in taking evidence is concerned, it is necessary that it be in public. If the action that my right hon. Friend has taken has in some way persuaded the majority of the Committee that the evidence should be taken in public, he will have done very useful work—not only for the Committee but for the House as whole. That is the reason why I shall be voting against the motion.

Sir Jim Spicer: I shall be very brief. When I was appointed to the Committee on Privileges, I really did count it to be a privilege. When I went to that Committee for the first time and saw the other members, I felt that I was amongst those Members of the House who would speak for the House as a whole, and not for their party. Above all, I felt that they would not speak for their own personal interests and ambitions. What horrifies me is that the Committee has now been delayed by nearly three months as a result of what has happened.
That may be acceptable to members of the Committee, but the hon. Member for Dewsbury (Mrs. Taylor) said that it was quite disgraceful that that should be so, and that we should have got down to the heart of the matter. Of course we should have, and that is what we all really want to do. The actions of the right hon. Member for Chesterfield (Mr. Benn) have made that quite impossible for the Committee. I deplore that, and we must put this affair behind us and get on with the task that we were given, which was to pass judgment—I say this and I mean it—as individual members of the Committee; riot as members of the Labour, Liberal Democrat or Conservative parties. The sooner we do so, the better it will be for the House and for the view that the country takes of the House.

Mr. David Alton: The hon. Member for Dorset, West (Sir J. Spicer) put his views very well on behalf of the members of the Committee who would have liked to see the right hon. Member for Chesterfield (Mr. Benn) remain a member of the Committee on Privileges.
It must be put on the record that the majority of Opposition Members voted for the meetings of the Committee to be held in public, but we were not aware at the time the first debate took place that the goalposts would be moved, and that we would then have a debate about the deliberative sessions also being held in public. That was a subsequent matter which was laid before the Committee. No matter how we had voted on the original motion, I do not believe that there would have been unanimity at that time, and we would not have therefore avoided the debate this evening. We are in a extraordinary position, because, despite having had a vote in the Committee of Privileges and a vote on the Floor of the House, some hon. Members are still demurring from the decision reached on those occasions.
Hon. Members must ultimately ask themselves whether something is so intrinsically evil that they cannot continue as members of the Committee. Despite the fact that I would like to see the evidence of that Committee taken in public, I do not believe that the issue merits the stance taken by the right hon. Member for Chesterfield. I suspect that it is a case of fighting the wrong battle in the last ditch. The right hon. Gentleman has led us along on an engaging argument, as he has done so often in the past, with which most can agree for 90 per cent. of the way, only to find that the final 10 per cent. is so far beyond that which was originally argued that it loses the support of the majority of those who might otherwise wish to support him.
I regret that we are in that position as a result of the publication of the right hon. Gentleman's version of Hansard, "Bennsard", which he says follows on from the

tradition of Cobbett and Hansard. In many ways, his publication follows the tradition of people such as Bakunin, because it has more to do with anarchy than democracy and abiding by majority decisions. The right hon. Gentleman is trying to insist on his own way, rather than abiding by a decision of the House.
The other issue before us is simple: the reputation of the House. As long ago as July, we were charged by the House with responsibility to decide on the issue of cash payments for questions. That matter has dragged on. We are agreed that that matter has brought the reputation of Parliament into disrepute and that it needs to be resolved quickly. In many ways, the scent has gone cold. Other issues must now be resolved: for example, the House has already referred the case of Mr. Peter Preston and the articles published by The Guardian to the Committee.
How can the Committee make progress if it has to spend all its time in a quagmire of debates on procedural questions and wrangling about the motion before the House? It is time wasting self-indulgence. It does nothing to enhance the reputation of the House and that is why I shall support the motion in the name of the Leader of the House.

Sir Giles Shaw: I support the decision that my right hon. Friend the Leader of the House took in casting his vote in the Committee in favour of the status quo. That follows precedent. It has been the tradition of all the Committees that that involving privileges is one which must be held in private.
It is absurd not only that the right hon. Member for Chesterfield (Mr. Benn) should have succeeded in delaying the Committee's proceedings for so long, but that he should have made his stand on the publication of his own view, not of the evidence before the Committee, but of the deliberations of the Committee. That was surely the one aspect of those two aspects that commanded no support in the Committee.
It is crucial that we undertake the prime purpose required of us by Madam Speaker to investigate the allegations against hon. Members. The idea that such an investigation should be held in public and before the television lights, as the hon. Member for Walsall, North (Mr. Winnick) would have us believe, is nothing more or less than soundbite judgment. I refuse to believe that that idea should be given any consideration in the laws of natural justice. We should not move towards a judicial procedure being hijacked in that fashion.
As for proceedings in the House, it is essential that the proper precedents are followed and the proper actions taken. The sooner we do that, the better.

Mr. D. N. Campbell-Savours: I opposed the original motion. If I recall it correctly, I voted against those on my Front Bench, because I believed that the Privileges Committee was riddled with commercial interests.
I hope that my right hon. Friend the Member for Chesterfield (Mr. Benn) will forgive me for what I am about to say, but I think that what he is doing is wrong. I have told him that privately and I think that he understands the position that I take.
I want to dwell on the issue of speaking freely. I have spent 12 years on the Public Accounts Committee, nine years on the Select Committee on Members' Interests and seven years on the Select Committee on Procedure. I have seen minds changed inside those Committees. I can remember hearing the Brown inquiry and the Mates inquiry, when people visibly changed their conclusions. They would never have done that had the cameras or the press been present in those Committees. They would never have reviewed their position.
I can remember a Procedure Committee meeting in 1990. I am not breaching privilege by saying that we were discussing a select committee for Northern Ireland. I do not want to reveal what happened on that occasion, but the Chairman of the Committee will remember the discussion. We could never have had that discussion if the Committee had met in public. I believe that what we did was in the public interest.
Over the years, I have sat on the Public Accounts Committee, when we have taken evidence. On one or two occasions I asked witnesses, "Would you be prepared to speak more freely if the public were not admitted to this Committee?" and have received an affirmative response. The truth is that people will not always speak freely if they know that what they say will be published.
I take the example of Mr. Ian Greer, giving evidence on lobbying to the Select Committee on Members' Interests. I can remember, without going into detail, a specific issue that Mr. Greer believed would be commercially sensitive. I shall not reveal what it was. I believe that we took the right decision in not publishing that information.
It being one and a half hours after the commencement of the proceedings on the motion, MADAM DEPUTY SPEAKER put the Question, pursuant to Order [9 December].

The House divided: Ayes 181, Noes 52.

Division No. 19]
[23.50 pm


AYES


Ainsworth, Peter (East Surrey)
Carlisle, Sir Kenneth (Lincoln)


Aitken, Rt Hon Jonathan
Chapman, Sydney


Alexander, Richard
Churchill, Mr


Alison, Rt Hon Michael (Selby)
Clappison, James


Allason, Rupert (Torbay)
Clarke, Rt Hon Kenneth (Ru'clif)


Alton, David
Coe, Sebastian


Amess, David
Conway, Derek


Arbuthnot, James
Coombs, Simon (Swindon)


Arnold, Jacques (Gravesham)
Cope, Rt Hon Sir John


Alkins, Robert
Currie, Mrs Edwina (S' D'by'ire)


Atkinson, Peter (Haxham)
Davies, Quentin (Stamford)


Baker, Nicholas (Dorset North)
Day, Stephen


Baldry,Tony
Deva, Nirj Joseph


Beresford, Sir Paul
Devlin,Tim


Bonsor,Nicholas
Dicks, Terry


Boswell, Tim
Dorrell, Rt Hon Stephen


Bottomley, Peter (Eltham)
Douglas-Hamilton, Lord James


Bottomley, Rt Hon Virginia
Duncan, Alan


Bowis, John
Dunn, Bob


Brandreth, Gyles
Durant, Sir Anthony


Bright, Sir Graham
Eggar, Tim


Browning, Mrs. Angela
Emery, Rt Hon Sir Peter


Butcher, John
Evans, David (Welwyn Hatfield)


Butler, Peter
Evans, Jonathan (Brecon)


Campbell, Menzies (Fife NE)
Evans, Nigel (Ribble Valley)


Carlile, Alexander (Montgomry)
Evans, Roger (Monmouth)





Evennett, David
Marshall, John (Hendon S)


Faber, David
Mawhinney, Rt Hon Dr Brian


Fabricant, Michael
McLoughlin, Patrick


Field, Barry (Isle of Wight)
Merchant, Piers


Forsyth, Michael (Stirling)
Mitchell, Andrew (Gedling)


Forth, Eric
Mitchell, Sir David (Hants NW)


Fox, Dr Liam (Woodspring)
Moate, Sir Roger


Fox, Sir Marcus (Shipley)
Needham, Rt Hon Richard


Freeman, Rt Hon Roger
Nelson, Anthony


French, Douglas
Neubert, Sir Michael


Gallie, Phil
Newton, Rt Hon Tony


Garnier, Edward
Nicholson, David (Taunton)


Gillan, Cheryl
Nicholson, Emma (Devon West)


Goodson-Wickes, Dr Charles
Norris, Steve


Gorst, Sir John
Onslow, Rt Hon Sir Cranley


Greenway, Harry (Ealing N)
Oppenheim, Phillip


Gummer, Rt Hon John Selwyn
Ottaway, Richard


Hague, William
Paice, James


Hanley, Rt Hon Jeremy
Pattie, Rt Hon Sir Geoffrey


Hannam, Sir John
Pickles, Eric


Hargreaves, Andrew
Portillo, Rt Hon Michael



Redwood, Rt Hon John


Harris, David
Rendel, David


Haselhurst, Alan
Richards, Rod


Heald, Oliver
Rifkind, Rt Hon Malcolm



Robertson, Raymond (Ab'd'n S)


Heathcoat-Amory, David
Robinson, Mark (Somerton)


Hendry, Charles
Rumbold, Rt Hon Dame Angela


Higgins, Rt Hon Sir Terence
Ryder, Rt Hon Richard


Hogg, Rt Hon Douglas (G'tham)
Shaw, David (Dover)


Hordern, Rt Hon Sir Peter
Shaw, Sir Giles(Pudsey)


Howard, Rt Hon Michael
Shephard, Rt Hon Gillian


Hughes, Robert G (Harrow W)
Shepherd, Colin (Hereford)


Hunt, Rt Hon David (Wirral W)
Shersby, Michael



Shore, Rt Hon Peter


Hurd, Rt Hon Douglas
Smith, Tim(Beaconsfield)


Jack, Michael
Spencer, Sir Derek


Jenkin, Bernard
Spicer, Sir James (W Dorset)


Jessel, Toby
Spink, Dr Robert


Johnson Smith, Sir Geoffrey
Spring, Richard


Jones, Gwilym (Cardiff N)
Sproat, Iain



Squire, Robin (Hornchurch)


Jones, Nigel (Cheltenham)
Stanley, Rt Hon Sir John


Jones, Robert B (W Hertfdshr)
Steel, Rt Hon Sir David


Jopling, Rt Hon Michael
Steen, Anthony


Kellett-Bowman, Dame Elaine
Stewart, Allan


Kirkhope, Timothy
Streeter, Gary


Knight, Dame Jill (Bir'm E'st'n)
Taylor, Ian (Esher)


Knight, Greg (Derby N)
Taylor, John M(Solihull)


Knight, Mrs Angela (Erewash)
Thompson, Patrick (Norwich N)


Kynoch, George (Kincardine)
Thompson, Sir Donald (C'er V)


Lait Mrs Jacqui
Thurnham, Peter



Tracey, Richard


Lang, Rt Hon Ian
Trend, Michael


Lester, Jim (Broxtowe)
Waller, Gary


Lidington, David
Wardle, Charles (Bexhill)


Lightbown, David
Waterson, Nigel


Lilley, Rt Hon Peter
Watts, John


Lloyd, Rt Hon Peter (Fareham)
Wells, Bowen


Luff, Peter
Whittingdale, John


Lyell, Rt Hon Sir Nicholas
Widdecombe, Ann


MacGregor, Rt Hon John
Willetts, David


MacKay, Andrew
Winterton, Mrs Ann (Congleton)


Maclean, David
Winterton, Nicholas (Macc'f'ld)



Wood, Timothy


Madel, Sir David
Young, Rt Hon Sir George


Maitland, Lady Olga
Tellers for the Ayes:


Malone, Gerald
Mr. Simon Burns and


Mans, Keith
Mr. Michael Bates.






NOES


Austin-Walker, John
Illsley, Eric


Banks, Tony (Newham NW)
Lewis, Terry


Barnes, Harry
Litherland, Robert


Bayley, Hugh
Livingstone, Ken


Benn, Rt Hon Tony
Llwyd, Elfyn


Burden, Richard
Macdonald, Calum


Caravan, Dennis
Mackinlay, Andrew


Chisholm, Malcolm
Madden, Max


Clapham, Michael
Mahon, Alice


Cohen, Harry
Marek, Dr John


Connarty, Michael
Meale, Alan


Corston, Jean
Michie, Bill (Sheffield Heeley)


Cunningham, Jim (Covy SE)
Morley, Elliot


Dalyell, Tam
Mullin, Chris


Davis, Terry (B'ham, H'dge H'I)
Pickthall, Colin


Ewing, Mrs Margaret
Pope, Greg


Fatchett, Derek
Simpson, Alan


Gerrard, Neil
Skinner, Dennis


Gordon, Mildred
Smith, Llew (Blaenau Gwent)


Grant Bernie (Tottenham)
Wareing, Robert N


Gunnell, John
Watson, Mike


Hain, Peter
Wicks, Malcolm


Hall, Mike
Williams, Alan W (Carmarthan)


Hanson, David
Winnick, David


Heppel, John



Hoyle, Doug
Tellers for the Noes:


Hughes, Kevin (Doncaster N)
Jeremy Corbyn and


Hughes, Robert (Aberdeen N)
Ronnie Campbell.

Question accordingly agreed to.

Ordered,
That Mr. Tony Benn be discharged from the Committee Privileges.

ESTIMATES

Motion made, and Question put forthwith, pursuant to Standing Order No. 131 (Liaison Committee),
That this House agrees with the Report [8th December] of the Liaison Committee.—[Mr. Wells.]
Question agreed to.

EDUCATION

Ordered,
That Mr. Dennis Turner be discharged from the Education Committee and Mr. Greg Pope be added to the Committee.—[Mr. Dixon.]

HEALTH

Ordered,
That Tessa Jowell be discharged from the Health Committee and Mr. John Austin-Walker be added to the Committee.—[Mr. Dixon]

HOME AFFAIRS

Ordered,
That Mr. Stephen Byers and Mrs. Barbara Roche be discharged from the Home Affairs Committee and Mr. John Hutton and Ms Janet Anderson be added to the Committee.—[Mr. Dixon.]

NORTHERN IRELAND AFFAIRS

Ordered,
That Mr. Jim Marshall be discharged from the Northern :Ireland Affairs Committee and Mr. Thomas McAvoy be added to the Committee.—[Mr. Dixon.]

SOCIAL SECURITY

Ordered,
That Mr. Jimmy Wray be discharged from the Social Security Committee and Mr. Malcolm Wicks be added to the Committee.— [Mr. Dixon.]

PETITION

Local Government (Buckinghamshire)

Mr. David Lidington: I rise to present a petition on behalf of some of my constituents and those of my hon. Friends who represent other Buckinghamshire constituencies. It reads:
To the House of Commons, The petition of the Friends of Buckinghamshire declares that the £13 million the Local Government Commission says it would cost to set up its new councils in Buckinghamshire and the ongoing costs of up to £5 million a year would be better spent on improvements to services provided by the existing county and district councils. Breaking the county up would damage important countywide services such as Education, social services and libraries. The MORI opinion poll carried out on behalf of the Commission showed that only 19 per cent of respondents favoured the four unitary council plan. Nearly twice as many said they wanted no change to existing councils, or change limited to the creation of a new council for Milton Keynes.
The petitioners therefore request that the House of Commons rejects the Local Government Commission's recommendations for Buckinghamshire.
The petitioners are headed by my noble Friend Lord Carrington, and an identical petition signed by 25,000 of people in Buckinghamshire has been presented to my right hon. Friend the Secretary of State for the Environment.
To lie upon the Table.

Stage Hypnotism

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Wells.]

Mr. Colin Pickthall: I am glad of the opportunity to raise this issue. I have been informed that the hon. Member for Beaconsfield (Mr. Smith) wishes to speak later, and I am happy with that, as I believe, is the Minster.
Stage hypnotism has been a long-standing concern of mine since I was alerted to its dangers by one of my constituents, Mrs. Margaret Harper. Some years ago, her daughter, Sharon Tabarn, was hypnotised at a club in Leyland in Lancashire. At the end of the trance, she was told to come out of it as if she had had a 10,000 volt electric shock. Her husband took her home in a somewhat dazed state, and five hours later she died.
The coroner's inquest found that this was an accidental death. The expert witness, a Dr. Heap, declared that there was no connection between hypnosis and any physical side-effects. That is patent nonsense. The Home Office pathologist said:
It is hard not to think there was a link.
My view is that the coincidence is too great to be dismissed and that evidence from other incidents shows that the link is likely to be real.
Following the tragedy, Mrs. Harper began, and still sustains, a campaign to ban stage hypnotism, and she has pulled together a vast amount of information, some of which I have sent to the Minister. I began to put questions to Ministers about the issue and was passed from one Department to another, no one seeming to want to take responsibility for the problem, although, to be fair, it crosses the responsibilities of Home Affairs in the context of licensing, of the Department of Health and of the Department of National Heritage, no doubt because of the stage element.
I was alarmed by the answer to a question from the Minister for Health, who wrote:
The Department has not investigated the medical effects of stage hypnotism and currently has no plans to do so."—[Official Report, 7 February 1994; Vol.237, c.52.]
On 15 March this year, a Home Office Minister answered a further question by writing that he had no present plans to review the licensing guidelines for acts of hypnosis, to institute a central register or code of conduct or to install compulsory public liability insurance. Given the level of concern and the obvious potential of misused or badly used hypnotism to do severe damage, those answers are unacceptable and complacent.
I have had letters from all over the country giving disturbing accounts of the effects of stage hypnosis, some of which I have passed to the Minister. I shall give some examples. Mr. Cannon from Barnet in the summer of 1992 was hypnotised and as a result he has had violent headaches ever since. He describes it as having made his life hell. A Mr. Hill of Rotherham was hypnotised by one Henry James—I do not think that it was the Henry James—and is subject to violent headaches, violent uncontrollable anger and persistent panic attacks. He was hospitalised several times on anti-depressants and has a permanent sleeping disorder.
Dean Chambers from Blackpool had his arm paralysed for four weeks as a result of the condition under which he was placed under hypnosis. A young man from High

Wycombe who was hypnotised by Paul McKenna, who is quite famous in this area, had to go to a psychiatric unit two days later where he was detained for six weeks and was still receiving treatment seven weeks later. While he was hypnotised he was put into regression, which is against the code of conduct, and was left unattended, which is also against the guidelines.
Mr. Nickson of Prestatyn became unable to work as a result of stage hypnotism, and was unable to hold a conversation and has attempted suicide. His case is attested by Mr. Trevelyn, the consultant psychiatrist for Clwyd. David Burill of Blackpool was hypnotised by Alan Bates and collapsed immediately after being brought round. He went crazy—his words—and had to be re-hypnotised by Bates. He suffered from violent headaches for weeks afterwards.
Ruth McLoughlin, a Glasgow university student, was hypnotised in October by Stefan Force and doctors found afterwards that her heart rate had dropped to a dangerously low level. Those are a few of the complaints that I and others have received.
Dr. Prem Meisra, who works in Glasgow, described a patient who became a compulsive eater of onions after being told to eat onions instead of apples while in a trance. It sounds funny but it is not. Another of his patients went into a trance again every time someone clapped, and a further patient began to suffer from a schizo-affective disorder.
This is plainly a highly dangerous business with potentially, perhaps actually, huge consequences for the national health service, as well as for the people concerned. In some instances, it may even have consequences for spectators. In the past, the Home Office has referred complainants first to the guidelines, which are worthless because they are largely ignored; secondly to the fact that responsibility for performances lies with local authorities; and thirdly to the Hypnotism Act 1952, which apparently covers the eventualities.
In August, on advice from doctors, Devon county council banned a stage hypnotism show by Mr. David Tabb. He used a loophole in the Act—the fact that, if stage hypnotism is called research, the licensing orders do not apply—and continued with his performance, which he called research, in a local pub. I shall quote Mr. Tabb's comment to Stage and Television Today on 25 August. He said:
Under the wording of the act you don't need permission for research so I just say my show is private research and there is nothing they can do. Basically the act is a load of wallop, but I haven't heard a dicky bird from the council since.
Obviously he is a man of great literary ability.
It is clear that the Act is not working as intended. Local authorities are reluctant to take cases to court because that is expensive and because they would end up prosecuting their local pubs, hall or other venues. We must separate the different groups involved.

Mr. David Nicholson: Could the hon. Gentleman be a little more specific about the place where the law was evaded? As I recollect, the event was due to take place in Taunton and the council that attempted to ban the performance was not Devon county council but


Taunton Deane borough council. It was on that basis that I raised the matter and corresponded with my hon. Friend the Minister.

Mr. Pickthall: That is correct. I have had correspondence about the event in Taunton Deane. We have some evidence of another event in Devon and another in Lincoln where the loophole was used. I also have experience locally in Preston where the local council, despite its views, was unable to ban a performance because the performer declared himself to be involved in research.
There are three different groups. First, there are the legitimate and trained professional users of hypnosis for medical reasons. I think that all their organisations want to ban stage hypnotism, which they feel brings their profession into disrepute. They also often have to unscramble the sad consequences of stage hypnotism. Secondly, there are the societies of stage hypnotists. They seek codes of conduct and licensing regulations that will protect the reputation of what they view as responsible stage hypnotism. There are two such organisations, both of which have been in touch with me about the debate. Both have asserted that they want a register of stage hypnotists, an enforceable code of conduct and the closure of the loophole in the Act.
Thirdly, there are the unorganised, individual pirates, many of whom seem not to care in the least about the after-effects of what they do. Obviously, that is the group about which we are most concerned. I understand that, for many people, it is relatively simple to learn to hypnotise someone else. It is possible for someone to learn quickly how to hypnotise people and within days to be doing so on stage, even though that person does not understand, and possibly does not care about, the consequences of what he is doing. It is those "cowboys", as the other groups call them, that we are most worried about.
I have not come here tonight to urge a ban on stage hypnotism. I am not in the business of declaring that that form of entertainment, which I personally find distasteful, should be banned, although my constituent—the mother of the lady whom I described at the beginning of my speech—would want that. Although my instinct is that a ban is needed, if I were to propose one I fear that the Minister would reject it out of hand. I recognise that the Government's policy is to remove regulations, so I ask at this point for an improving alteration to the regulations.
Furthermore, attention should be paid to making the guidelines more effective and binding. In the longer term—I recognise that this is outside the Minister's remit, although I hope that he feels that it is reasonable to support it—it is vital that the Department of Health examines the effects of stage hypnotism on people who are liable to suffer badly from its after-effects. After all, it is a medical matter. We would not entertain for a moment the idea of untrained, unskilled, unlicensed people operating on people's bodies—in public, for that matter—but we seem to be prepared to allow untrained, unlicensed people to operate in people's minds in public.
The Department of Health should examine the behaviour and expertise—or lack of it—of some stage hypnotists whose victims claim have done them serious damage. Such research should enable sound judgments to be made on whether the Campaign Against Stage Hypnotism is correct in its demand for a ban on health and safety grounds.
Because the effect of hypnotism can be funny, it is easy to turn it into a funny subject. It is, however, extremely serious and many people have been seriously hurt by it. I hope that the Minister, in so far as his remit with the Home Office allows, can offer some assurance that the matter will at least be looked into.

Mr. Tim Smith: I congratulate the hon. Member for Lancashire, West (Mr. Pickthall) on raising the subject of stage hypnotism, which is clearly a serious and growing problem.
My constituent, Miss Gibbs, has raised with me the case of Mr. Christopher Gates. On 10 march this year, they went to see the Paul McKenna hypnotic show at the Wycombe Swan theatre, where Mr. Gates was hypnotised for more than two hours. As the hon. Gentleman said, Home Office guidelines were not followed, as he was put into regression and left unattended throughout the interval. After the show, he felt unwell. He was referred to a psychiatric unit for four weeks. Nine months later, his condition has deteriorated severely, and he now thinks of himself as eight years old and behaves like an eight-year-old. He must be accompanied by an adult at all times.
I hope that my hon. Friend the Minister will investigate this matter with the seriousness that it deserves. I want the Home Office guidelines strengthened and effectively enforced.

The Minister of State, Home Office (Mr. Michael Forsyth): I congratulate the hon. Member for Lancashire, West (Mr. Pickthall) on securing the opportunity to discuss the topic of stage hypnotism. I am not sure whether he is aware that we have in our presence a former president of the Federation of Ethical Stage Hypnotists in the shape of the Under-Secretary of State for Schools, my hon. Friend the Member for Homchurch (Mr. Squire), so I answer this debate with considerable trepidation. Hypnotism is not a subject that features regularly in the House's deliberations, although it may offer some answers to the problems that have been experienced of late.
I entirely accept the hon. Gentleman's point that this is a serious matter, and I am sure that I speak for everyone in the House in extending my sympathy to the hon. Gentleman's constituents—the family of Mrs. Tabarn— who died so unexpectedly last year. I fully understand the distress and sense of loss experienced by her daughter.
I will begin by describing the legislation that applies to public exhibitions of hypnotism. Under the Hypnotism Act 1952, licensing authorities for public entertainments—district councils and London boroughs—may attach conditions to public entertainment licences to regulate or to prohibit exhibitions or performances of hypnotism. In places where no public entertainments licence is in force—because, for example, no music or dancing takes place—the licensing authority's authorisation is still required before any public exhibition of hypnotism takes place.

Mr. Nirj Joseph Deva: I am not an expert on stage hypnotism or any other form, but if one is willing to be hypnotised, one is acquiescing. It


is a matter of personal choice. How does one strike a balance between personal choice and the adverse effects that may result?

Mr. Forsyth: I agree with my hon. Friend that personal choice is exerted when deciding to be hypnotised, but the whole point is that, once one is hypnotised, personal choice is somewhat diminished. That is the reasoning behind the legislation.
The licensing authority may specify conditions on which the exhibition shall take place. Anyone who gives a public performance of hypnotism as an entertainment without authority, or in contravention of a condition of licence, commits an offence. So does anyone who hypnotises a person under the age of 18 as part of a public performance. Demonstrations of hypnotism for scientific or research purposes, or in the course of medical treatment, are outside the scope of the controls in the 1952 Act.
The concern of the hon. Member for Lancashire, West stems from Mrs. Tabarn's untimely death last year, only a few hours after she had been hypnotised in the course of a public display at the public house where she worked. I certainly understand her family's feeling that the two events were connected, but, as I understand it, the coroner did not find a connection, and his verdict was that Mrs. Tabarn's death was due to natural causes.
The hon. Member for Lancashire, West mentioned the Home Office pathologist, and I saw a letter that he sent to Sheffield university in which he stated that, as far as he was concerned, there was no evidence that the hypnosis show the night before could have brought on the cause of Mrs. Tabarn's death.
I am aware also that opinion is divided on whether people taking part in exhibitions of hypnotism can suffer physical or psychological harm as a result. I am not aware of any incontrovertible evidence of harm. It seems that there is not a case for banning stage hypnotism altogether, as some have advocated—although the hon. Gentleman distanced himself from that view this evening.
Although watching or participating in a display of hypnotism may not be everybody's cup of tea, it is clearly an entertaining and enjoyable experience for many people. The hon. Member for Lancashire, West recently sent me some papers about hypnotism that included letters from members of the public claiming that they or someone they know suffered adverse effects.
I thank my hon. Friend the Member for Beaconsfield (Mr. Smith) for his contribution. He also wrote to me on behalf of a constituent who feels that her friend suffered after-effects following a demonstration of stage hypnotism. I am not competent to judge whether or not those claims are valid.
Another question that has arisen about the 1952 Act in the last few months is whether it can be effectively enforced. My hon. Friend the member for Taunton (Mr. Nicholson) has been in touch with me about an unauthorised display of hypnotism in a public house in his constituency. It seems that the hypnotist concerned claimed that the performance was being conducted for research, and argued that he needed no licence or other authorisation because of the exemption that I mentioned earlier.
It is not for me to interpret the law in that or any other particular case, but it seems questionable whether a performance of hypnotism in a public house can genuinely be described as research. However, the local licensing authority, on which responsibility for enforcing the requirements of the Hypnotism Act 1952 rests, did not feel able to initiate a prosecution.
Further concerns over enforcement were raised by an article published in October in Stage and Television Today, which the hon. Gentleman drew to my attention. It suggested that other stage hypnotists were to conduct demonstrations for research purposes, so avoiding the licensing requirements of the Hypnotism Act. Clearly, if it were possible to circumvent the controls in the Act on entertainments involving hypnotism simply by labelling the performance "research", the purpose of the Act would be undermined.
In fact, the issues arising out of stage hypnotism and the legislation controlling it have never been clear-cut. The Home Office issued guidance to licensing authorities in 1953, at about the time when the Hypnotism Act came into force. That guidance was revised in 1989, and issued as a Home Office circular to local authorities. The circular is quite detailed: it sets out the legal provisions of the 1952 Act, and provides model conditions that licensing authorities might wish to apply to entertainment licences either to prohibit or to control exhibitions of hypnotism.
The circular suggests the conditions that might be imposed if an authority chose to regulate rather than prohibit public exhibitions of hypnotism. They include a requirement that the exhibition shall be conducted in such a way as not to be likely to cause harm to anyone attending it. Although it is not obligatory for licensing authorities to impose the model conditions set out in the Home Office circular, I understand that many do so.
It seems clear, therefore, that there are genuine concerns—whether justified or not—about the possible adverse consequences that some people might suffer after participating in performances of stage hypnotism. In addition, there are apparently problems over enforcing the controls in the Hypnotism Act; as a result, performances are taking place that are not licensed, but no action is brought against those who may have breached the licensing requirements.
Indeed, I believe that the event in Lancashire to which the hon. Member for Lancashire, West referred was not licensed or otherwise authorised, but that no proceedings were instituted. I understand, however, that the licensing council concerned subsequently advised all venues where public performances of hypnotism might take place of the licensing requirements, and of the sanctions and penalties that unlicensed performances could entail.
In all the circumstances, I do not think that we can let matters rest. Like other Departments, the Home Office is progressively reviewing regulatory legislation for which it is responsible. The purpose of those reviews is essentially deregulatory, to remove unnecessary constraints and controls; but when regulation is essential it will be retained, and it can be strengthened if public safety requirements suggest that that is necessary.
I am impressed by the representations that I have received from my hon. Friends and the hon. Member for Lancashire, West, and it is therefore my intention that officials review the workings of the Hypnotism Act shortly.

Mr. David Nicholson: I am glad to hear how seriously my hon. Friend and the Home Office are taking the matter. May I remind my hon. Friend that I have intervened not only on behalf of my local authority but on behalf of Avon and Somerset police, whose job it is to enforce the law in this regard?

Mr. Forsyth: Indeed. My hon. Friend has drawn my attention to representations from the police and the local authority, and that played no small part in persuading me that we had to take the matter extremely seriously.
That is why a review will take place. It will examine evidence of the possible risk of harm to people taking part in public entertainments involving hypnotism, and the

appropriateness of the present regime of control that the Act provides. The Home Office guidelines will also be scrutinised.
The review will examine the arrangements for enforcement and, if necessary, prosecution, to establish whether the present arrangements are satisfactory. It will draw on medical expertise, and will involve consultations with all interested parties—particularly the local authorities on which responsibility for licensing and enforcement falls.
Clearly, I cannot anticipate the outcome of the review. It may reveal that no substantial change is needed; but I think that the Government need to consider very carefully whether the arrangements established more than 40 years ago for the control of public exhibitions of hypnotism remain the right way in which to deal with today's circumstances.
I thank the hon. Member for Lancashire, West for providing an opportunity for us to debate an important and interesting topic.
Question put and agreed to.
Adjourned accordingly at half-past Twelve midnight.